Category: Nevin Manimala

Zhongguo Zhen Jiu. 2022 Oct 12;42(10):1115-9. doi: 10.13703/j.0255-2930.20211124-k0009.

ABSTRACT

OBJECTIVE: To observe the anti-anxiety effect of electroacupuncture at Baihui (GV 20) and Sishencong (EX-HN 1) in patients with gynecological laparoscopic surgery, and to explore its effect on the anesthetic dosage during anesthesia induction.

METHODS: A total of 270 patients with gynecological laparoscopic surgery were randomized into an electroacupuncture group, a medication group and a control group, 90 cases in each group. At 24 h and 2 h before anesthesia induction, electroacupuncture was applied at Baihui (GV 20) and Sishencong (EX-HN 1) in the electroacupuncture group, with continuous wave, 100 Hz in frequency. At 30 min before anesthesia induction, midazolam of 0.02 mg/kg was given by intravenous drip in the medication group, while 0.9% sodium chloride solution was given by intravenous drip in the control group. At 10 min before anesthesia induction and 6 h after surgery, the scores of 6 item short form of state-trait anxiety inventory (STAI-S6) and visual analogue scale-anxiety (VAS-A) were observed; at 10 min before anesthesia induction (T1) and observer’s assessment of alertness/sedation scale (OAA/S) grade 4 (T2), mean artery pressure (MAP), heart rate (HR) and value of bispectral index (BIS) were recorded; the dosage of propofol at T2 was recorded and the surgery related adverse reactions were compared among the 3 groups.

RESULTS: At 10 min before anesthesia induction and 6 h after surgery, the STAI-S6 and VAS-A scores in the electroacupuncture group and the medication group were lower than those in the control group (P<0.05). Values of BIS at T1 and dosage of propofol at T2 in the electroacupuncture group and the medication group were lower than those in the control group (P<0.05). There were no statistical differences in MAP, HR and surgery related adverse reactions among the 3 groups (P>0.05).

CONCLUSION: Electroacupuncture at Baihui (GV 20) and Sishencong (EX-HN 1) can effectively relieve the presurgical anxiety in patients with gynecological laparoscopic surgery, and reduce the dosage of propofol, its effect is similar to traditional anti-anxiety drug.

PMID:37199201 | DOI:10.13703/j.0255-2930.20211124-k0009

Phys Chem Chem Phys. 2023 May 18. doi: 10.1039/d2cp06083c. Online ahead of print.

ABSTRACT

A.D. is a common disease among other neurodegenerative disorders primarily developing due to amyloid-β (Aβ) neurotoxicity derived from the amyloid-β protein precursor (AβPP). The amyloid precursor-like proteins 1 and 2 (APP1 and APLP2) biochemically behave similarly in many aspects to AβPP. We, therefore, proposed to test WGX-50 and Alpha-M for their interaction mechanism with APLP1 and APLP2 because both these drug candidate compounds previously showed inhibition of Aβ aggregation. We employed a comparative atomic investigation on Alpha-M and WGX-50 in complex with novel targets, i.e., APLP1 and APLP2, using biophysical and molecular simulation methods. The docking score was -6.83 kcal mol^-1 for Alpha-M-APLP1, -8.41 kcal mol^-1 for WGX-50-APLP1, -7.02 kcal mol^-1 for Alpha-M-APLP2 and -8.25 kcal mol^-1 for the WGX-50-APLP2 complex. Our results also elaborate that in the case of their interaction with both APLP1 and APLP2, the WGX-50 complex exhibits better stability than the APLP1/2-Alpha-M complexes during simulation. Furthermore, WGX50 in both APLP1 and APLP2 stabilized the internal flexibility upon binding in contrast to the Alpha-M complexes. The data showed that the BFE for Alpha-M-APLP1 was calculated to be -27.38 ± 0.93 kcal mol^-1, for WGX-50-APLP1 -39.65 ± 0.95 kcal mol^-1, for Alpha-M-APLP2 -24.80 ± 0.63 kcal mol^-1 while for WGX-50-APLP2 the BFE was -57.16 ± 1.03 kcal mol^-1 respectively. These results highlight that APLP2-WGX50 has greater binding energies in all four systems. PCA and FEL analysis further revealed variations in the dynamic behavior of these complexes. Overall, our findings demonstrate that WGX50 potentially acts as a more potent inhibitor for APLP1 and APLP2 than Alpha-M and thus shows the diverse pharmacological potential of WGX50. Due to its stable binding interaction, WGX50 might be a suitable candidate drug compound for targeting these precursors under pathological conditions.

PMID:37199163 | DOI:10.1039/d2cp06083c

Arterioscler Thromb Vasc Biol. 2023 May 18. doi: 10.1161/ATVBAHA.123.319156. Online ahead of print.

NO ABSTRACT

PMID:37199158 | DOI:10.1161/ATVBAHA.123.319156

Circulation. 2023 May 18. doi: 10.1161/CIRCULATIONAHA.123.064053. Online ahead of print.

ABSTRACT

BACKGROUND: Existing data and clinical trials could not determine whether faster intravenous thrombolytic therapy (IVT) translates into better long-term functional outcomes after acute ischemic stroke among those treated with endovascular thrombectomy (EVT). Patient-level national data can provide the required large population to study the associations between earlier IVT, versus later, with longitudinal functional outcomes and mortality in patients receiving IVT+EVT combined treatment.

METHODS: This cohort study included older US patients (age ≥65 years) who received IVT within 4.5 hours or EVT within 7 hours after acute ischemic stroke using the linked 2015 to 2018 Get With The Guidelines-Stroke and Medicare database (38 913 treated with IVT only and 3946 with IVT+EVT). Primary outcome was home time, a patient-prioritized functional outcome. Secondary outcomes included all-cause mortality in 1 year. Multivariate logistic regression and Cox proportional hazards models were used to evaluate the associations between door-to-needle (DTN) times and outcomes.

RESULTS: Among patients treated with IVT+EVT, after adjusting for patient and hospital factors, including onset-to-EVT times, each 15-minute increase in DTN times for IVT was associated with significantly higher odds of zero home time in a year (never discharged to home) (adjusted odds ratio, 1.12 [95% CI, 1.06-1.19]), less home time among those discharged to home (adjusted odds ratio, 0.93 per 1% of 365 days [95% CI, 0.89-0.98]), and higher all-cause mortality (adjusted hazard ratio, 1.07 [95% CI, 1.02-1.11]). These associations were also statistically significant among patients treated with IVT but at a modest degree (adjusted odds ratio, 1.04 for zero home time, 0.96 per 1% home time for those discharged to home, and adjusted hazard ratio 1.03 for mortality). In the secondary analysis where the IVT+EVT group was compared with 3704 patients treated with EVT only, shorter DTN times (≤60, 45, and 30 minutes) achieved incrementally more home time in a year, and more modified Rankin Scale 0 to 2 at discharge (22.3%, 23.4%, and 25.0%, respectively) versus EVT only (16.4%, P<0.001 for each). The benefit dissipated with DTN>60 minutes.

CONCLUSIONS: Among older patients with stroke treated with either IVT only or IVT+EVT, shorter DTN times are associated with better long-term functional outcomes and lower mortality. These findings support further efforts to accelerate thrombolytic administration in all eligible patients, including EVT candidates.

PMID:37199147 | DOI:10.1161/CIRCULATIONAHA.123.064053

Biom J. 2023 May 18:e2200108. doi: 10.1002/bimj.202200108. Online ahead of print.

ABSTRACT

Logistic regression is one of the most commonly used approaches to develop clinical risk prediction models. Developers of such models often rely on approaches that aim to minimize the risk of overfitting and improve predictive performance of the logistic model, such as through likelihood penalization and variance decomposition techniques. We present an extensive simulation study that compares the out-of-sample predictive performance of risk prediction models derived using the elastic net, with Lasso and ridge as special cases, and variance decomposition techniques, namely, incomplete principal component regression and incomplete partial least squares regression. We varied the expected events per variable, event fraction, number of candidate predictors, presence of noise predictors, and the presence of sparse predictors in a full-factorial design. Predictive performance was compared on measures of discrimination, calibration, and prediction error. Simulation metamodels were derived to explain the performance differences within model derivation approaches. Our results indicate that, on average, prediction models developed using penalization and variance decomposition approaches outperform models developed using ordinary maximum likelihood estimation, with penalization approaches being consistently superior over the variance decomposition approaches. Differences in performance were most pronounced on the calibration of the model. Performance differences regarding prediction error and concordance statistic outcomes were often small between approaches. The use of likelihood penalization and variance decomposition techniques methods was illustrated in the context of peripheral arterial disease.

PMID:37199142 | DOI:10.1002/bimj.202200108

Haematologica. 2023 May 18. doi: 10.3324/haematol.2023.282935. Online ahead of print.

ABSTRACT

Androgens have represented the historical therapeutic backbone of bone marrow failure (BMF) syndromes. However, their role has been rarely analyzed in prospective setting and systematic and long-term data are currently unavailable regarding their usage, effectiveness and toxicity in both acquired and inherited BMF. Here, taking advantage of a unique disease-specific international dataset, we retrospectively analyzed the so far largest cohort of BMF patients who received androgens before or in absence of an allogeneic hematopoietic cell transplantation (HCT), reappraising their current use in these disorders. We identified 274 patients across 82 EBMT affiliated centers, 193 with acquired (median age of 32) and 81 with inherited BMF (median age of 8 years). With a median duration of androgen treatment of 5.6 and 20 months respectively, complete/partial remission rates at 3 months were of 6%/29% in acquired and 8%/29% in inherited disorders. Five-year overall survival and failure free survival (FFS) were respectively 63% and 23% in acquired and 78% and 14% in inherited contexts. Androgen initiation after second line treatments for acquired, and after > 12 months post-diagnosis for inherited group were identified as factors associated with improved FFS in multivariable analysis. Androgen use was associated with a manageable incidence of organ-specific toxicity and low rates of solid and hematological malignancies. Sub-analysis of transplant-related outcomes after exposure to these compounds showed probabilities of survival and complications similar to other transplanted BMF cohorts. This study delivers a unique opportunity to track androgen use in BMF syndromes and represents the basis for general recommendations on their use on behalf of the SAAWP of the EBMT.

PMID:37199126 | DOI:10.3324/haematol.2023.282935

Pediatrics. 2023 May 18:e2022058579. doi: 10.1542/peds.2022-058579. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with a language for care other than English (LOE) face communication barriers and inequitable outcomes in health care. Professional interpretation can improve outcomes but is underutilized. Our pediatric emergency department (ED) implemented quality improvement (QI) interventions over a 5-year period with an aim to increase interpreter use to 80% of patient encounters with LOE.

METHODS: Overall interpreter use for ED encounters was measured over time, with a baseline period of October 2015 to December 2016 and during 5 years of QI interventions from January 2017 to August 2021. Interventions included staff education, data feedback, reducing barriers to interpreter use, and improving identification of language for care with plan-do-study-act cycles. Outcomes were analyzed by using statistical process control charts and standard rules for special cause variation.

RESULTS: We analyzed a total of 277 309 ED encounters during the study period, 12.2% with LOE. The overall use of interpretation increased from a baseline of 53% to 82% of encounters. Interpretation throughout the ED visit and the number of interpreted interactions per hour also increased. There was improvement across language types, patient age groups, acuity levels, and during different times of day. Special cause variation was associated with multiple QI interventions.

CONCLUSION: We reached our primary aim of providing professional interpretation for 80% of patient encounters with LOE. There were several QI interventions associated with improvements, including staff education, data feedback, improved access to interpretation, and improved identification and visualization of language for care. Efforts to improve interpreter use may benefit from a similar multifaceted approach.

PMID:37199106 | DOI:10.1542/peds.2022-058579

J Child Adolesc Psychiatr Nurs. 2023 May 18. doi: 10.1111/jcap.12422. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to examine the mediating effect of a sense of coherence (SOC) in the relationship between eating attitudes and self-esteem in adolescents.

METHODS: The study was conducted in a descriptive-correlational exploratory design. The sample of the study consisted of 1175 adolescents who met the inclusion criteria. Data were obtained by the researchers using personal information form, the Sense of Coherence Scale (SOC-13), the Eatıng Attitude Test (EAT-26), and the Rosenberg Self-Esteem Scale (RSES).

RESULTS: SOC-13 mean score was 50.21 ± 11.06, EAT-26 mean score was 14.53 ± 10.17, and RSES mean score was 4.17 ± 1.66. It was found that there was a statistically significant negative relationship between the mean scores of RSES and the EAT, a positive relationship between the mean scores of the RSES and SOC, and a negative relationship between the mean scores of EAT and SOC. Moreover, the mediating role of SOC was found to be moderate. Furthermore, 4.5% of adolescents’ SOC scores are explained by eating attitude. On the other hand, 16.4% of self-esteem scores are explained by eating attitude and SOC.

CONCLUSION: As a result of this study, it was determined that students’ SOC moderately mediated the relationship between eating attitude and self-esteem. At the same time, eating attitude had a direct predictive effect on self-esteem.

PMID:37199070 | DOI:10.1111/jcap.12422

J Clin Ultrasound. 2023 May 18. doi: 10.1002/jcu.23476. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to evaluate fetal epicardial fat thickness (EFT) along with fetal myocardial performance index (MPI) and its effects on perinatal outcomes in non-severe idiopathic polyhydramnios (IP).

MATERIALS AND METHODS: This prospective study included 92 participants, 32 diagnosed with non-severe IP, and 60 healthy pregnant women. Amniotic fluid indices (AFI), umbilical and middle cerebral artery Doppler, EFT, and MPI measurements were performed for all patients.

RESULTS: The fetal EFT and MPI values were statistically higher in the non-severe IP group than in the control group (p = 0.0001, p = 0.014, respectively). The optimal fetal EFT cutoff value for predicting non-severe IP disease was found as 1.3 mm with a specificity of 81.7% and sensitivity of 59.4%. The EFT cutoff for predicting cesarean section in non-severe IP cases was 1.25 mm (p = 0.038). Apgar scores, neonatal intensive care unit, respiratory distress syndrome, and stillbirth rates were not different between groups.

CONCLUSION: In this study, EFT and MPI were found to be higher in non-severe IP cases compared to controls. It was observed that the increase in MPI and EFT was associated with the increase in cesarean rates, but not with adverse fetal outcomes.

PMID:37199060 | DOI:10.1002/jcu.23476

Cancer Med. 2023 May 18. doi: 10.1002/cam4.6095. Online ahead of print.

ABSTRACT

BACKGROUND: The rising cancer incidence in patients with oral leukoplakia (OL) highlights the importance of identifying potential biomarkers for high-risk individuals and lesions because these biomarkers are useful in developing personalized management strategies for OL patients. This study systematically searched and analyzed the literature on potential saliva and serum biomarkers for OL malignant transformation.

METHODS: PubMed and Scopus were searched for studies published up to April 2022. The primary outcome of this study was the difference in biomarker concentrations in saliva or serum samples from healthy control (HC), OL and oral cancer (OC) populations. Cohen’s d with 95% credible interval was calculated and pooled using the inverse variance heterogeneity method.

RESULTS: A total of seven saliva biomarkers were analyzed in this paper, including interleukin-1alpha, interleukin-6 (IL-6), interleukin-6-8, tumor necrosis factor alpha (TNF-α), copper, zinc, and lactate dehydrogenase. IL-6 and TNF-α exhibited statistically significant deviations in comparisons between HC versus OL and OL versus OC. A total of 13 serum biomarkers were analyzed, including IL-6, TNF-α, C-reactive protein, total cholesterol, triglycerides, high-density lipoproteins, low-density lipoproteins, albumin, protein, β2-microglobulin, fucose, lipid-bound sialic acid (LSA), and total sialic acid (TSA). LSA and TSA exhibited statistically significant deviations in comparisons between HC versus OL and OL versus OC.

CONCLUSION: IL-6 and TNF-α in saliva have strong predictive values for OL deterioration, and LSA and TSA concentration levels in serum also have the potential to serve as biomarkers for OL deterioration.

PMID:37199052 | DOI:10.1002/cam4.6095