Category: Nevin Manimala

Leuk Res Rep. 2023 Oct 28;20:100392. doi: 10.1016/j.lrr.2023.100392. eCollection 2023.

ABSTRACT

BACKGROUND: The nonrandom recurrence of chromosomal abnormalities in multiple myeloma (MM) raises the possibility that they play a role in the pathophysiology and development of the disease. Fluorescence in situ hybridization (FISH) can identify a high frequency of certain abnormalities without the need for the proliferative and infiltrative index of malignant plasma cells required for conventional cytogenetic analysis. In this study, we describe the association between clinico-biological characteristics and chromosomal abnormalities in 30 Moroccan patients.

METHODS: The analysis of cytogenetic data, conventional and molecular, of 30 cases of MM, obtained from our previously cytogenetic study, and correlation of the results with the clinico-biological data of these patients.

RESULTS: The bone marrow of 5 of 21 patients (23 %) contained a chromosomally abnormal clone, and all karyotypes were complicated (>3 abnormalities). Interphase FISH (iFISH) has detected aberrations in 14 out of 30 (46 %) of the total cases. The proportion of plasma cells in the bone marrow was higher in patients with chromosomal abnormalities (median 29 %) (p = 0.01917) than in patients without abnormalities (median 11 %). Although there was a difference in the median ß-2 microglobulin percentage (13.8 % versus 6.8 %), it was not statistically significant (p = 0.6818). We also, categorized patients into those with a complex clone and those with a sole abnormality. Patients with high bone marrow plasma cell rate (median 45 %) and high rate of ß-2 microglobulin (median 24 %) showed a complex karyotype and a higher iFISH detection rate than those with plasma cells count for (median 20 %) and ß-2 microglobulin count for (median 11 %) but without statistical significance (p = 0.4338 et p = 0.45 respectively). Furthermore, patients with aberrations had significantly shorter overall survival (100 % for 800 days versus 150 days only).

CONCLUSION: Our research has shown that different subgroups of patients with MM can be classified based on the underlying genetic abnormalities. Chromosomal abnormalities (CA) may give the plasma cell a proliferative advantage, increasing the virulence of the disease and affecting overall survival.

PMID:38035181 | PMC:PMC10685041 | DOI:10.1016/j.lrr.2023.100392

Cannabis. 2023 Nov 3;6(3):127-138. doi: 10.26828/cannabis/2023/000173. eCollection 2023.

ABSTRACT

Guided Self-Change (GSC) is a Motivational Interviewing (MI)-based early intervention program, infused with Cognitive Behavioral Therapy (CBT), for individuals with substance use problems. In this study, we implemented a 4-session GSC program with the innovative addition of mindfulness-based techniques at a minority-serving institution to reduce substance use and negative consequences among self-referred university students. We investigated processes that may be associated with behavior change, including perceived risk of use and self-efficacy ratings among university students who reported their primary substance of choice was cannabis (n = 18) or alcohol (n = 18). The sample of 36 participants (M_age = 24.4, SD_age = 5, range 18-37) mostly identified as female (58.3%), then male (41.7%); 52.8% identified as Hispanic/Latine, 22.2% as Black or African American, and 19.5% as a sexual minority. Among cannabis primary using students, results indicated that the perceived risk of weekly cannabis use, confidence to change, and readiness to change showed statistically significant increases from pre- to post-assessment. Among alcohol primary using students, confidence to change and readiness to change showed statistically significant increases from pre- to post-assessments. All results yielded large effect sizes, which may be inflated due to the small sample size. Findings suggest that over the course of participation in a brief, 4-session targeted GSC program, there were significant increases in perceived risk and self-efficacy among minority university students who engage in primary cannabis or primary alcohol use.

PMID:38035169 | PMC:PMC10683752 | DOI:10.26828/cannabis/2023/000173

Pan Afr Med J. 2023 Sep 11;46:13. doi: 10.11604/pamj.2023.46.13.41152. eCollection 2023.

ABSTRACT

INTRODUCTION: HIV-1 and Mtb are characterized by immune activation and unbalances production of cytokines, but the expression of IL33 in HIV/TB coinfection remain understudied. This study aimed to evaluate the level of IL-33 in plasma of HIV and M. tuberculosis (HIV/TB) coinfected patients compared to patients with respective mono infections in Yaoundé.

METHODS: a cross-sectional study was conducted among patients attending the pneumology service and HIV treatment center of the Yaoundé Jamot Hospital. Plasma samples of 157 HIV/TB coinfected patients (n =26, 50% males and 50% females, mean age 39), HIV-1 monoinfected patients (n = 41, 41% males and 59% females, mean age 35), TB monoinfected patients (n = 48, 56% males and 44% females, mean age 37) and healthy controls (n = 42, 29% males and 71% females, mean age 32) were examined by enzyme-linked immunoassay (ELISA) to detect the levels of IL-33 cytokine.

RESULTS: plasma level of IL-33 were higher in HIV/TB coinfected (33.1±30.9 pg/ml) and TB monoinfected individuals (15.1±2.9 pg/ml) compared to healthy controls (14.0±3.4 pg/ml) and could not be detected in most of the HIV-1 monoinfected individuals (12.6±8.7 pg/ml). Interestingly, the increased plasma level of IL-33 in HIV/TB coinfected patients showed a statistically significant difference between healthy controls (33.1±30.9 pg/ml vs 14.0±3.4 pg/ml, P<0.0001) and HIV-1 monoinfected patients (33.1±30.9 pg/ml vs 12.6±8.7 pg/ml, P=0.0002). We further found that IL-33 was higher in patients with high viral load group (40.6±59.7 pg/ml vs 12.6±1.8 pg/ml), P= 0.47) whereas patients under highly active antiretroviral therapy (HAART) showed decreased level of IL-33 concentration as the number of years under ART increased. Our data showed a positive association between plasma IL-33 and viral load in the context of HIV/TB coinfection in our study population with a positive Pearson coefficient of r=0.21.

CONCLUSION: this study indicates that plasma level of IL-33 differs among HIV/TB coinfected patients and respective monoinfections patients. The increased level of plasma IL-33 reveals that IL-33 measurement in HIV-1 monoinfected patients may represent an early predictor of development of tuberculosis.

PMID:38035159 | PMC:PMC10683167 | DOI:10.11604/pamj.2023.46.13.41152

Pan Afr Med J. 2023 Sep 11;46:11. doi: 10.11604/pamj.2023.46.11.40984. eCollection 2023.

ABSTRACT

This review explores task shifting and task sharing in sub-Saharan African healthcare to address workforce shortages and cost-effectiveness. Task shifting allocates tasks logically, while task sharing involves more workers taking on specific duties. Challenges include supply chain issues, pay inadequacy, and weak supervision. Guidelines and success measures are lacking. Initiating these practices requires evaluating factors and ensuring sustainability. Task shifting saves costs but needs training and support. Task sharing boosts efficiency, enabling skilled clinicians to contribute effectively. To advance task shifting and sharing in the region, further research is needed to scale up effective initiatives. Clear success indicators, monitoring, evaluation, and learning plans, along with exploration of sustainability and appropriateness dimensions, are crucial elements to consider.

PMID:38035152 | PMC:PMC10683172 | DOI:10.11604/pamj.2023.46.11.40984

Cardiovasc J Afr. 2023 Nov 29;34:1-6. doi: 10.5830/CVJA-2023-061. Online ahead of print.

ABSTRACT

INTRODUCTION: The aim of this study was to investigate the effects of ellagic, vanillic and rosmarinic acid on reperfusion-related kidney damage, developed in an experimental lower-extremity ischaemia/reperfusion (I/R) model.

METHODS: Forty-eight female Sprague-Dawley rats were divided into six groups. A median laparotomy and dissection were performed. In the I/R group, 60 minutes of ischaemia followed by 120 minutes of reperfusion was achieved. In addition one group was given 100 mg/kg ellagic acid, one group was given 12 mg/kg vanillic acid, one group was given 50 mg/kg rosmarinic acid and one group was given all three drugs 15 minutes before clamp removal. Bilateral kidney and blood samples were taken in all groups.

RESULTS: Tubular epithelial degeneration, necrosis of the tubule epithelium and vessel wall thickening were significantly higher in the I/R group. Some parameters in the groups that were given drugs were found to be lower than in the I/R group and close to that of the control group. Total oxidant status (TOS) and oxidative stress index (OSI) were significantly higher and total antioxidant status (TAS) was significantly lower in the I/R group. Although not statistically significant in the groups given drugs, TAS was higher, and TOS and OSI were lower than in the I/R group.

CONCLUSION: The antioxidant effect of ellagic, vanillic and rosmarinic acid administration may have beneficial effects on renal damage after reperfusion in acute lower-extremity ischaemia. This study is expected to provide information for future clinical trials.

PMID:38032731 | DOI:10.5830/CVJA-2023-061

J Med Internet Res. 2023 Nov 30;25:e49074. doi: 10.2196/49074.

ABSTRACT

BACKGROUND: Users increasingly use social networking services (SNSs) to share their feelings and emotions. For those with mental disorders, SNSs can also be used to seek advice on mental health issues. One available SNS is Reddit, in which users can freely discuss such matters on relevant health diagnostic subreddits.

OBJECTIVE: In this study, we analyzed the distinctive linguistic characteristics in users’ posts on specific mental disorder subreddits (depression, anxiety, bipolar disorder, borderline personality disorder, schizophrenia, autism, and mental health) and further validated their distinctiveness externally by comparing them with posts of subreddits not related to mental illness. We also confirmed that these differences in linguistic formulations can be learned through a machine learning process.

METHODS: Reddit posts uploaded by users were collected for our research. We used various statistical analysis methods in Linguistic Inquiry and Word Count (LIWC) software, including 1-way ANOVA and subsequent post hoc tests, to see sentiment differences in various lexical features within mental health-related subreddits and against unrelated ones. We also applied 3 supervised and unsupervised clustering methods for both cases after extracting textual features from posts on each subreddit using bidirectional encoder representations from transformers (BERT) to ensure that our data set is suitable for further machine learning or deep learning tasks.

RESULTS: We collected 3,133,509 posts of 919,722 Reddit users. The results using the data indicated that there are notable linguistic differences among the subreddits, consistent with the findings of prior research. The findings from LIWC analyses revealed that patients with each mental health issue show significantly different lexical and semantic patterns, such as word count or emotion, throughout their online social networking activities, with P<.001 for all cases. Furthermore, distinctive features of each subreddit group were successfully identified through supervised and unsupervised clustering methods, using the BERT embeddings extracted from textual posts. This distinctiveness was reflected in the Davies-Bouldin scores ranging from 0.222 to 0.397 and the silhouette scores ranging from 0.639 to 0.803 in the former case, with scores of 1.638 and 0.729, respectively, in the latter case.

CONCLUSIONS: By taking a multifaceted approach, analyzing textual posts related to mental health issues using statistical, natural language processing, and machine learning techniques, our approach provides insights into aspects of recent lexical usage and information about the linguistic characteristics of patients with specific mental health issues, which can inform clinicians about patients’ mental health in diagnostic terms to aid online intervention. Our findings can further promote research areas involving linguistic analysis and machine learning approaches for patients with mental health issues by identifying and detecting mentally vulnerable groups of people online.

PMID:38032730 | DOI:10.2196/49074

JMIR Public Health Surveill. 2023 Nov 30;9:e45870. doi: 10.2196/45870.

ABSTRACT

BACKGROUND: Other infectious diarrhea (OID) continues to pose a significant public health threat to all age groups in Fujian Province. There is a need for an in-depth analysis to understand the epidemiological pattern of OID and its associated risk factors in the region.

OBJECTIVE: In this study, we aimed to describe the overall epidemic characteristics and spatiotemporal pattern of OID in Fujian Province from 2005 to 2021 and explore the linkage between sociodemographic and environmental factors and the occurrence of OID within the study area.

METHODS: Notification data for OID in Fujian were extracted from the China Information System for Disease Control and Prevention. The spatiotemporal pattern of OID was analyzed using Moran index and Kulldorff scan statistics. The seasonality of and short-term impact of meteorological factors on OID were examined using an additive decomposition model and a generalized additive model. Geographical weighted regression and generalized linear mixed model were used to identify potential risk factors.

RESULTS: A total of 388,636 OID cases were recorded in Fujian Province from January 2005 to December 2021, with an average annual incidence of 60.3 (SD 16.7) per 100,000 population. Children aged <2 years accounted for 50.7% (196,905/388,636) of all cases. There was a steady increase in OID from 2005 to 2017 and a clear seasonal shift in OID cases from autumn to winter and spring between 2005 and 2020. Higher maximum temperature, atmospheric pressure, humidity, and precipitation were linked to a higher number of deseasonalized OID cases. The spatial and temporal aggregations were concentrated in Zhangzhou City and Xiamen City for 17 study years. Furthermore, the clustered areas exhibited a dynamic spreading trend, expanding from the southernmost Fujian to the southeast and then southward over time. Factors such as densely populated areas with a large <1-year-old population, less economically developed areas, and higher pollution levels contributed to OID cases in Fujian Province.

CONCLUSIONS: This study revealed a distinct distribution of OID incidence across different population groups, seasons, and regions in Fujian Province. Zhangzhou City and Xiamen City were identified as the major hot spots for OID. Therefore, prevention and control efforts should prioritize these specific hot spots and highly susceptible groups.

PMID:38032713 | DOI:10.2196/45870

JMIR Res Protoc. 2023 Nov 30;12:e47978. doi: 10.2196/47978.

ABSTRACT

BACKGROUND: Though rates of tobacco smoking have decreased consistently over the past 3 decades, cigarette use remains the top preventable cause of premature death in North America. The Clinical Effort Against Secondhand Smoke Exposure (CEASE) is a medical clinic-based intervention that systematically screens parents for tobacco use and offers them direct access to evidence-based smoking cessation services. While the effectiveness of CEASE for parents who smoke has already been demonstrated in the United States, the CEASE model has not yet been tested in Canada, among parents who use e-cigarettes, or among adolescents who use cigarettes and e-cigarettes.

OBJECTIVE: We aim to demonstrate the feasibility and evaluate the preliminary effectiveness of the CEASE program for parental smoking cessation and its adapted version for adolescent smoking cessation and adolescent and parental vaping cessation.

METHODS: We will approach parents or guardians of children aged between 0 and 17 years, as well as adolescent patients aged between 14 and 17 years, from a tertiary care pediatric hospital in Montreal, Quebec, Canada, for participation in this single-blinded, pilot randomized controlled trial. Eligible participants are those who report using tobacco cigarettes or e-cigarettes at least once in the last 7 days and present to an outpatient pediatric clinic for a scheduled appointment. Our recruitment target is 100 participants: 50 parents or guardians of children aged 17 years or younger, and 50 adolescents aged between 14 and 17 years. The feasibility of implementation of the CEASE model will be measured by recruitment and retention rates for all 4 participant groups (stratified as follows: parents who use cigarettes, parents who use e-cigarettes exclusively, adolescents who use cigarettes, and adolescents who use e-cigarettes exclusively). Parent and adolescent participants within each group are randomized to the intervention and control groups using a 1:1 ratio through a computer-generated randomization list. Preliminary effectiveness outcomes include self-reported smoking and e-cigarette cessation, use of cessation resources, changes in smoking and e-cigarette use, motivation to quit, and quit attempts among participants. Participants complete electronic questionnaires on a tablet in the clinic at baseline as well as electronic follow-up questionnaires at 1, 3, and 6 months. Individuals reporting successful quit attempts are invited to provide a urine sample for cotinine testing to biochemically confirm quit. Analyses include descriptive statistics as well as exploratory trajectory analyses of smoking, e-cigarette use, and motivation to quit.

RESULTS: Research activities began in June 2022. Participant enrollment and data collection began in February 2023 and are expected to be completed in 15 months.

CONCLUSIONS: There is a strong need for effective and cost-effective smoking and vaping cessation interventions for parents and adolescents. If successful, this study will help inform the preparation of a fully powered randomized controlled trial of CEASE in Canada in these populations.

TRIAL REGISTRATION: Clinicaltrials.gov NCT05366790; https://www.clinicaltrials.gov/study/NCT05366790.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/47978.

PMID:38032712 | DOI:10.2196/47978

JMIR Rehabil Assist Technol. 2023 Nov 30;10:e45307. doi: 10.2196/45307.

ABSTRACT

BACKGROUND: Building up physical activity is a highly important aspect in an older patient’s rehabilitation process after hip fracture surgery. The patterns of physical activity during rehabilitation are associated with the duration of rehabilitation stay. Predicting physical activity patterns early in the rehabilitation phase can provide patients and health care professionals an early indication of the duration of rehabilitation stay as well as insight into the degree of patients’ recovery for timely adaptive interventions.

OBJECTIVE: This study aims to explore the early prediction of physical activity patterns in older patients rehabilitating after hip fracture surgery at a skilled nursing home.

METHODS: The physical activity of patients aged ≥70 years with surgically treated hip fracture was continuously monitored using an accelerometer during rehabilitation at a skilled nursing home. Physical activity patterns were described in our previous study, and the 2 most common patterns were used in this study for pattern prediction: the upward linear pattern (n=15) and the S-shape pattern (n=23). Features from the intensity of physical activity were calculated for time windows with different window sizes of the first 5, 6, 7, and 8 days to assess the early rehabilitation moment in which the patterns could be predicted most accurately. Those features were statistical features, amplitude features, and morphological features. Furthermore, the Barthel Index, Fracture Mobility Score, Functional Ambulation Categories, and the Montreal Cognitive Assessment score were used as clinical features. With the correlation-based feature selection method, relevant features were selected that were highly correlated with the physical activity patterns and uncorrelated with other features. Multiple classifiers were used: decision trees, discriminant analysis, logistic regression, support vector machines, nearest neighbors, and ensemble classifiers. The performance of the prediction models was assessed by calculating precision, recall, and F₁-score (accuracy measure) for each individual physical activity pattern. Furthermore, the overall performance of the prediction model was calculated by calculating the F₁-score for all physical activity patterns together.

RESULTS: The amplitude feature describing the overall intensity of physical activity on the first day of rehabilitation and the morphological features describing the shape of the patterns were selected as relevant features for all time windows. Relevant features extracted from the first 7 days with a cosine k-nearest neighbor model reached the highest overall prediction performance (micro F₁-score=1) and a 100% correct classification of the 2 most common physical activity patterns.

CONCLUSIONS: Continuous monitoring of the physical activity of older patients in the first week of hip fracture rehabilitation results in an early physical activity pattern prediction. In the future, continuous physical activity monitoring can offer the possibility to predict the duration of rehabilitation stay, assess the recovery progress during hip fracture rehabilitation, and benefit health care organizations, health care professionals, and patients themselves.

PMID:38032703 | DOI:10.2196/45307

Cardiovasc J Afr. 2023 Nov 20;34:1-5. doi: 10.5830/CVJA-2023-057. Online ahead of print.

ABSTRACT

OBJECTIVE: The choroidal vascularity index (CVI) is a method that measures the density of blood vessels in the choroidal layer and can be used to evaluate the effects of hypertension. In this study we aimed to investigate the relationship between epicardial fat thickness (EFT) and CVI in patients with hypertension.

METHODS: This prospective study included 112 patients diagnosed with hypertension and 120 healthy individuals. Patients’ demographic data such as age, gender, weight, height, body mass index (BMI), smoking status, and presence of coronary artery disease and diabetes mellitus were recorded. BMI was calculated by dividing a patient’s weight in kilograms by their height in metres squared. EFT was measured by echocardiography and CVI was calculated using the optical coherence tomography method.

RESULTS: The mean CVI was found to be 66.57 ± 2.21 in the patient group and 69.22 ± 2.39 in the control group and the difference was significant (p < 0.001). The mean EFT was found to be 5.23 ± 3.25 mm in the patients and 2.57 ± 1.97 mm in the control group and the difference was statistically significant (p = 0.003). According to Spearman’s correlation analysis, there was a significant positive correlation between BMI and EFT (r = 0.379, p < 0.001) and a significant negative correlation between CVI and EFT (r = -0.412, p < 0.001).

CONCLUSION: The CVI value was significantly lower and the EFT value was significantly higher in patients with hypertension compared to non-hypertensive patients. There was a significant positive correlation between EFT and BMI and a significant negative correlation between EFT and CVI.

PMID:38032688 | DOI:10.5830/CVJA-2023-057