Category: Nevin Manimala

Curr Eye Res. 2023 Apr 3:1-9. doi: 10.1080/02713683.2023.2192896. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the correlation between lens density measured by IOL-Master 700 based on swept-source optical coherence tomography (SS-OCT) technology and the phacodynamic parameters of Centurion phacoemulsification in cataract surgery.

METHODS: This prospective study included 66 patients (83 eyes) with age-related cataracts. Using the Lens Opacities Classification System III (LOCS III), the lens nuclear color (NC), lens nuclear opalescence (NO), cortical (C), and posterior subcapsular (P) opacities were obtained. Six meridian orientations of IOL-Master 700 images were captured, and the lens and nuclear regions were analyzed using ImageJ to generate the average lens nucleus density (AND) and average lens density (ALD). Phacodynamic parameters were recorded. The correlation between lens density and the phacodynamic parameters was analyzed. According to the AND, patients were divided into four groups (soft, medium-hard, hard, and extremely hard nucleus), and the phacodynamic parameters were compared among groups.

RESULTS: The correlation between the AND obtained by LOCS III grading and SS-OCT-based cataract quantification system score (NC and NO) was statistically significant (r_NC = 0.795, r_NO=0.794, both p = .000). AND correlated significantly with cumulative dissipated energy (CDE, r = 0.545, p = .000), total ultrasound time (TUST, r = 0.354, p = .001), and total torsional ultrasound time (TTUT, r = 0.314, p = .004). Among the four groups divided by AND, the difference in CDE (P₁₃ = 0.002, P₁₄ < 0.001, P₂₄ = 0.002) was statistically significant.

CONCLUSION: AND measured by IOL-Master 700, SS-OCT correlated significantly with LOCS III classification and phacodynamic parameters of the Centurion system, especially with CDE, TUST, and TTUT. AND can be used as an indicator for quantitative evaluation and help inform the surgical plan.

PMID:37009774 | DOI:10.1080/02713683.2023.2192896

Immunotherapy. 2023 Apr 3. doi: 10.2217/imt-2022-0190. Online ahead of print.

ABSTRACT

There is a critical need for novel therapies to treat patients with advanced biliary tract cancer (BTC). This systematic review summarizes the evidence-based knowledge for the potential role of PD-1 and PD-L1 monoclonal antibodies in the treatment of patients with early-stage and advanced BTC. An Embase database search was conducted, identifying 15 eligible phase II/III clinical trials for review. Results from recent phase III trials show a statistically significant overall survival (OS) benefit from the addition of PD-1/PD-L1 inhibitors to chemotherapy in the first-line management of advanced BTC. Future research should concentrate on the discovery of biomarkers to identify patients who would benefit most from these therapies.

PMID:37009698 | DOI:10.2217/imt-2022-0190

Ann Hum Genet. 2023 Apr 3. doi: 10.1111/ahg.12506. Online ahead of print.

ABSTRACT

INTRODUCTION: Observational studies have shown that body mass index (BMI) and waist-to-hip ratio (WHR) are both inversely associated with lung function, as assessed by forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1). However, observational data are susceptible to confounding and reverse causation.

METHODS: We selected genetic instruments based on their relevant large-scale genome-wide association studies. Summary statistics of lung function and asthma came from the UK Biobank and SpiroMeta Consortium meta-analysis (n = 400,102). After examining pleiotropy and removing outliers, we applied inverse-variance weighting to estimate the causal association of BMI and BMI-adjusted WHR (WHRadjBMI) with FVC, FEV1, FEV1/FVC, and asthma. Sensitivity analyses were performed using weighted median, MR-Egger, and MRlap methods.

RESULTS: We found that BMI was inversely associated with FVC (effect estimate, -0.167; 95% confidence interval (CI), -0.203 to -0.130) and FEV1 (effect estimate, -0.111; 95%CI, -0.149 to -0.074). Higher BMI was associated with higher FEV1/FVC (effect estimate, 0.079; 95%CI, 0.049 to 0.110) but was not significantly associated with asthma. WHRadjBMI was inversely associated with FVC (effect estimate, -0.132; 95%CI, -0.180 to -0.084) but has no significant association with FEV1. Higher WHR was associated with higher FEV1/FVC (effect estimate, 0.181; 95%CI, 0.130 to 0.232) and with increased risk of asthma (effect estimate, 0.027; 95%CI, 0.001 to 0.053).

CONCLUSION: We found significant evidence that increased BMI is suggested to be causally related to decreased FVC and FEV1, and increased BMI-adjusted WHR could lead to lower FVC value and higher risk of asthma. Higher BMI and BMI-adjusted WHR were suggested to be causally associated with higher FEV1/FVC.

PMID:37009668 | DOI:10.1111/ahg.12506

Analyst. 2023 Apr 3. doi: 10.1039/d2an02057b. Online ahead of print.

ABSTRACT

Early and accurate diagnosis of gastric cancer is vital for effective and targeted treatment. It is known that glycosylation profiles differ in the cancer tissue development process. This study aimed to profile the N-glycans in gastric cancer tissues to predict gastric cancer using machine learning algorithms. The (glyco-) proteins of formalin-fixed parafilm embedded (FFPE) gastric cancer and adjacent control tissues were extracted by chloroform/methanol extraction after the conventional deparaffinization step. The N-glycans were released and labeled with a 2-amino benzoic (2-AA) tag. The MALDI-MS analysis of the 2-AA labeled N-glycans was performed in negative ionization mode, and fifty-nine N-glycan structures were determined. The relative and analyte areas of the detected N-glycans were extracted from the obtained data. Statistical analyses identified significant expression levels of 14 different N-glycans in gastric cancer tissues. The data were separated based on the physical characteristics of N-glycans and used to test in machine-learning models. It was determined that the multilayer perceptron (MLP) was the most appropriate model with the highest sensitivity, specificity, accuracy, Matthews correlation coefficient, and f1 scores for each dataset. The highest accuracy score (96.0 ± 1.3) was obtained from the whole N-glycans relative area dataset, and the AUC value was determined as 0.98. It was concluded that gastric cancer tissues could be distinguished from adjacent control tissues with high accuracy using mass spectrometry-based N-glycomic data.

PMID:37009642 | DOI:10.1039/d2an02057b

MDM Policy Pract. 2023 Mar 27;8(1):23814683231163190. doi: 10.1177/23814683231163190. eCollection 2023 Jan-Jun.

ABSTRACT

Background. Personal autonomy in lung cancer screening is advocated internationally, but health systems diverge in their approach, mandating either shared decision making (with a health care professional) or individual decision making. Studies of other cancer screening programs have found that individual preferences for the level of involvement in screening decisions vary across different sociodemographic groups and that aligning approaches with individual preferences has the potential to improve uptake. Method. For the first time, we examined preferences for decision control among a cohort of UK-based high-risk lung cancer screening candidates (N = 727). We used descriptive statistics to report the distribution of preferences and chi-square tests to examine associations between decision preferences and sociodemographic variables. Results. Most (69.7%) preferred to be involved in the decision with varying degrees of input from a health care professional. Few (10.2%) wanted to make the decision alone. Preferences were also associated with educational attainment. Conclusion. These findings suggest one-size-fits-all approaches may be inadequate in meeting diverse preferences, particularly those placing sole onus on the individual.

HIGHLIGHTS: Preferences for involvement in decision making about lung cancer screening are heterogeneous among high-risk individuals in the United Kingdom and vary by educational attainment.Further work is needed to understand how policy makers might implement hybrid approaches to accommodate individual preferences and optimize lung cancer screening program outcomes.

PMID:37009636 | PMC:PMC10064161 | DOI:10.1177/23814683231163190

Int J Paramed. 2023 Jan-Mar;1(1):73-84. doi: 10.56068/ampo6844. Epub 2023 Jan 9.

ABSTRACT

BACKGROUND: Anticipating an increased utilization of healthcare facilities during the COVID-19 surge, the San Francisco Department of Public Health developed a plan to deploy neighborhood-based Field Care Clinics (FCCs) that would decompress emergency departments by serving patients with low acuity complaints. These clinics would receive patients directly from the Emergency Medical Services (EMS) system. Transports were initiated by a paramedic-driven protocol, originally by EMS crews and later by the Centralized Ambulance Destination Determination (CADDiE) System. In this study, we evaluated the outcomes of EMS patients who were transported to the FCC, specifically as to whether they required subsequent transfer to the emergency department.

METHODS: We performed a retrospective study of all patients transported to the Bayview-Hunters Point (BHP) neighborhood FCC by EMS between April 11^th, 2020, and December 16^th, 2020. Descriptive statistics and Chi-Square Tests were used to analyze patient data.

RESULTS: In total, 35 patients (20 men, 15 women, average age of 50.9 years) were transported to the FCC. Of these, 16 were Black/African American, 7 were White, 3 were Asian, with 9 identifying as of other races and 9 of Hispanic ethnicity. Twenty-three of these transports resulted from a CADDiE recommendation. Approximately half (n=20) of calls originated within the BHP neighborhood. The most frequent patient complaint was “Pain.” Of patients transported to the FCC, 23 were treated and discharged. The 12 remaining patients required hospital transfer, with 3 being discharged after receiving treatment in the emergency department and 9 requiring hospital admission, psychiatric, or sobering services. The likelihood of hospital transfer did not significantly vary by sex (p=0.41), 9-1-1 call origination relative to BHP neighborhood (p=0.92), or CADDiE recommendation (p=0.51).

CONCLUSION: Three-fourths of patients who required subsequent hospital transfer were admitted or required specialized services, suggesting that the FCC was viable for managing low acuity conditions. However, the underutilization of the FCC by EMS as a transport destination and a high hospital transfer rate indicates training and protocol refinement opportunities. Despite the small cohort size, this study demonstrates that an FCC alternative care site can act as a viable source for urgent and emergency care during a pandemic.

PMID:37009632 | PMC:PMC10062198 | DOI:10.56068/ampo6844

Chaos Solitons Fractals. 2023 May;170:113395. doi: 10.1016/j.chaos.2023.113395. Epub 2023 Mar 27.

ABSTRACT

This paper presents a stochastic model for COVID-19 that takes into account factors such as incubation times, vaccine effectiveness, and quarantine periods in the spread of the virus in symptomatically contagious populations. The paper outlines the conditions necessary for the existence and uniqueness of a global solution for the stochastic model. Additionally, the paper employs nonlinear analysis to demonstrate some results on the ergodic aspect of the stochastic model. The model is also simulated and compared to deterministic dynamics. To validate and demonstrate the usefulness of the proposed system, the paper compares the results of the infected class with actual cases from Iraq, Bangladesh, and Croatia. Furthermore, the paper visualizes the impact of vaccination rates and transition rates on the dynamics of infected people in the infected class.

PMID:37009628 | PMC:PMC10040364 | DOI:10.1016/j.chaos.2023.113395

Front Surg. 2023 Mar 15;10:1120030. doi: 10.3389/fsurg.2023.1120030. eCollection 2023.

ABSTRACT

PURPOSE: This study sought to conduct several three-dimensional measurements of the distal ulna in healthy Han Chinese, providing the anatomical basis for the diagnosis and treatment of hand trauma, distal ulnar disorders, and the design of wrist prostheses.

METHODS: 50 Han Chinese men and women that underwent computed tomography (CT) scans of the distal ulnar carpus were included in the present study. A three-dimensional digital model of the distal ulna was reconstructed using Mimics software. Moreover, the anatomical data of 10 indicators were measured using MIMICS software. Each index data was measured by 2 investigators independently, and the average value was taken. The data were stratified and compared between left and right sides and men and women.

RESULTS: A 3D digital model of the distal ulnar bone with a realistic shape was reconstructed. The 10 anatomical parameters measured are as follows: The length of the ulnar styloid process (posterior anterior), The length of the ulnar styloid process(anterior and posterior); the transverse diameter of the ulnar head; the anteroposterior diameter of the ulnar head. The radial inclination angle of the ulna; the ulnar inclination angle; the distal space between the ulna and radius; the ulnar notch angle of the lower radius. The anterior and posterior diameters of the ulnar notch of the lower radius, and the superior and inferior diameters of the ulnar notch of the lower radius. Statistical analysis showed no significant difference after stratification by laterality and gender.

CONCLUSION: our findings can providing the anatomical basis for the diagnosis and treatment of hand trauma, distal ulnar disorders and further improve currently available wrist joint prostheses.

TYPE OF STUDY: Observational, Cross-sectional study, LOE: Level II.

PMID:37009615 | PMC:PMC10050329 | DOI:10.3389/fsurg.2023.1120030

Front Surg. 2023 Mar 15;10:1112473. doi: 10.3389/fsurg.2023.1112473. eCollection 2023.

ABSTRACT

OBJECTIVES: The inflammatory response caused by gastric cancer surgery and the low nutritional status of patients with gastric cancer can cause growth of tumour cells, reduce immunity, and increase tumour burden. We investigated the effects of different surgical methods on postoperative inflammatory response and nutritional status in patients with distal gastric cancer.

METHODS: Clinical data of 249 patients who underwent radical distal gastrectomy for distal gastric cancer from February 2014 to April 2017 were retrospectively analysed. Patients were divided according to the surgical method (open distal gastrectomy [ODG], laparoscopic-assisted distal gastrectomy [LADG] and total laparoscopic distal gastrectomy [TLDG]). Characteristics of different surgical procedures, including inflammation parameters and nutritional indicators, and different time points (preoperatively, 1 day postoperatively, and 1 week postoperatively) were compared using non-parametric test analysis.

RESULTS: At postoperative day 1, white blood cell count [WBC], neutrophil count [N], neutrophil/lymphocyte ratio [NLR], and platelet/lymphocyte ratio [PLR] increased in the three groups, and ΔN and ΔNLR were significant; the smallest change was observed in TLDG (P < 0.05). Albumin [A]and prognostic nutrition index [PNI] significantly decreased; the smallest ΔA and ΔPNI, which were statistically significant, were noted in TLDG. One week postoperatively, WBC, N, NLR, and PLR decreased, and WBC, N, and NLR showed significant difference. A and PNI of the three groups increased after 1 week, and A and PNI showed significant differences.

CONCLUSION: Postoperative inflammatory response and nutritional status of patients with distal gastric cancer are associated with the surgical technique. TLDG has little influence on the inflammatory response and nutritional level compared with LADG and ODG.

PMID:37009613 | PMC:PMC10050336 | DOI:10.3389/fsurg.2023.1112473

Front Surg. 2023 Mar 16;10:1130919. doi: 10.3389/fsurg.2023.1130919. eCollection 2023.

ABSTRACT

OBJECTIVE: Cardiopulmonary exercise testing (CPET) is currently recommended for all patients undergoing lung resection with either respiratory comorbidities or functional limitations. The main parameter evaluated is oxygen consumption at peak (VO₂peak). Patients with VO₂peak above 20 ml/kg/min are classified as low risk surgical candidates. The aims of this study were to evaluate postoperative outcomes of low-risk patients, and to compare their outcomes with those of patients without pulmonary impairment at respiratory function testing.

METHODS: Retrospective monocentric observational study was designed, evaluating outcomes of patients undergoing lung resection at San Paolo University Hospital, Milan, Italy, between January 2016 and November 2021, preoperatively assessed by CPET, according to 2009 ERS/ESTS guidelines. All low-risk patients undergoing any extent surgical lung resection for pulmonary nodules were enrolled. Postoperative major cardiopulmonary complications or death, occurring within 30 days from surgery, were assessed. A case-control study was nested, matching 1:1 for type of surgery the cohort population with control patients without functional respiratory impairment consecutively undergoing surgery at the same centre in the study period.

RESULTS: A total of 80 patients were enrolled: 40 subjects were preoperatively assessed by CPET and deemed at low risk, whereas 40 subjects represented the control group. Among the first, 4 patients (10%) developed major cardiopulmonary complications, and 1 patient (2.5%) died within 30 days from surgery. In the control group, 2 patients (5%) developed complications and none of the patients (0%) died. The differences in morbidity and mortality rates did not reach statistically significance. Instead, age, weight, BMI, smoking history, COPD incidence, surgical approach, FEV1, Tiffenau, DLCO and length of hospital stay resulted significantly different between the two groups. At a case-by-case analysis, CPET revealed a pathological pattern in each complicated patient, in spite of VO₂peak above target for safe surgery.

CONCLUSIONS: Postoperative outcomes of low-risk patients undergoing lung resections are comparable to those of patients without any pulmonary functional impairment; nonetheless the formers represent a dramatically different category of individuals from the latter and may harbour few patients with worse outcomes. CPET variables overall interpretation may add to the VO₂peak in identifying higher risk patients, even in this subgroup.

PMID:37009610 | PMC:PMC10062454 | DOI:10.3389/fsurg.2023.1130919