Category: Nevin Manimala

J Robot Surg. 2023 Apr 17. doi: 10.1007/s11701-023-01600-3. Online ahead of print.

ABSTRACT

As life expectancy continues to rise, there is a growing cohort of octogenarians that can have oncologic benefit from a partial nephrectomy. This study aims to analyze a large national dataset to compare the safety and outcomes in octogenarians receiving a nephrectomy. The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was utilized. All subjects 80-89 years old who received a minimally invasive partial nephrectomy (CPT: 50543) or radical nephrectomy (CPT: 50545, 50546) from 2016 to 2020 were included. Baseline characteristics, comorbidities, and postoperative complications were compared. Chi-square analysis and student t-tests were used to analyze categorical and continuous variables, respectively. 1765 procedures were performed on octogenarians, of which 1299 (73.6%) received a radical nephrectomy and 466 (26.4%) received a partial nephrectomy. When comparing preoperative comorbidities, octogenarians undergoing partial nephrectomy had lower rates of dyspnea at exertion (7.3 vs. 10.6%, p = 0.04), COPD (2.8 vs. 5.9%, p = 0.01), and chronic steroid use (1.5 vs. 3.3%, p = 0.04). No statistically significant differences were seen in any minor (Clavien 1/2) or major post-operative complications (Clavien 3/4). Readmissions were higher in those who received a partial nephrectomy (10.5 vs. 6.5%, p = 0.01); however, there were no significant differences in reoperation (2.4 vs. 1.7%, p = 0.36) or mortality (1.3 vs. 1.8%, p = 0.48). Partial nephrectomy is a safe and feasible operation in octogenarians. Preoperative counseling and appropriate patient selection remain imperative.

PMID:37067699 | DOI:10.1007/s11701-023-01600-3

Int Ophthalmol. 2023 Apr 17. doi: 10.1007/s10792-023-02702-5. Online ahead of print.

ABSTRACT

PURPOSE: To compare characteristics of unilateral vs. bilateral thyroid eye disease (TED).

METHODS: This retrospective analytical cross-sectional study was conducted on patients with TED who were evaluated at an academic referral center over a 6-year period. We compared demographics, activity (clinical activity score) and severity (EUGOGO classification) of TED, thyroid disease duration, TED duration, the time interval between thyroid and eye involvement, thyroid function status, and clinical signs between bilateral and unilateral TED.

RESULTS: Three hundred eighty-three patients including 213 females (55.6%), who had a mean age of 40.23 ± 13.72 years, were enrolled. Active TED was seen in 8.8% of bilateral and none of unilateral cases (P = 0.04). Bilateral TED patients had more severe disease (P = 0.001). The distribution of hyperthyroidism, hypothyroidism, and euthyroidism was significantly different between unilateral and bilateral groups (P = 0.001). Abnormal ocular motility was present in 26.3% versus 2.3% of bilateral and unilateral ones, respectively (P = 0.001). Proptosis was more prevalent in bilateral than unilateral cases (P = 0.001). We did not observe any statistically significant difference between the two groups in others variables.

CONCLUSION: Bilateral TED patients present with more severity, activity, movement abnormality, proptosis, and hyperthyroidism.

PMID:37067696 | DOI:10.1007/s10792-023-02702-5

ACS Synth Biol. 2023 Apr 17. doi: 10.1021/acssynbio.2c00662. Online ahead of print.

ABSTRACT

Oxygen-independent, flavin mononucleotide-based fluorescent proteins (FbFPs) are promising alternatives to green fluorescent protein in anaerobic contexts. Deep mutational scanning performs systematic profiling of protein sequence-function relationships but has not been applied to FbFPs. Focusing on CreiLOV from Chlamydomonas reinhardtii, we created and analyzed two comprehensive mutant collections: (1) single-residue, site-saturation mutagenesis libraries covering all 118 residues; and (2) a full combinatorial metagenesis library among 20 mutations at 15 residues, where mutation and residue selection was based on single-site mutagenesis results. Notably, the second type of library is indispensable to study higher-order epistasis but underrepresented in the literature. Using optimized FACS-seq assays, 2,185 (>92.5%) out of 2,360 possible single-site mutants and 165,428 (>89.7%) out of 184,320 possible combinatorial mutants were reliably assigned with fitness values. We constructed statistical and machine-learning models to analyze the CreiLOV data set, enabling accurate fitness prediction of higher-order mutants using lower-order mutagenesis data. In addition, we successfully isolated CreiLOV variants with improved fluorescence quantum yield and thermostability. This work provides new empirical data and design rules to engineer combinatorial protein variants.

PMID:37066862 | DOI:10.1021/acssynbio.2c00662

Biometrics. 2023 Apr 17. doi: 10.1111/biom.13870. Online ahead of print.

ABSTRACT

Finite mixture of regressions (fmr) are commonly used to model heterogeneous effects of covariates on a response variable in settings where there are unknown underlying subpopulations. fmrs, however, cannot accommodate situations where covariates’ effects also vary according to an “index” variable-known as finite mixture of varying coefficient regression (fm-vcr). Although complex, this situation occurs in real data applications: the osteocalcin (OCN) data analyzed in this manuscript presents a heterogeneous relationship where the effect of a genetic variant on OCN in each hidden subpopulation varies over time. Oftentimes, the number of covariates with varying coefficients also presents a challenge: in the OCN study, genetic variants on the same chromosome are considered jointly. The relative proportions of hidden subpopulations may also change over time. Nevertheless, existing methods cannot provide suitable solutions for accommodating all these features in real data applications. To fill this gap, we develop statistical methodologies based on regularized local-kernel likelihood for simultaneous parameter estimation and variable selection in sparse fm-vcr models. We study large-sample properties of the proposed methods. We then carry out a simulation study to evaluate the performance of various penalties adopted for our regularized approach and ascertain the ability of a bic-type criterion for estimating the number of subpopulations. Finally, we applied the fm-vcr model to analyze the OCN data and identified several covariates, including genetic variants, that have age-dependent effects on osteocalcin. This article is protected by copyright. All rights reserved.

PMID:37066855 | DOI:10.1111/biom.13870

Int J Dent Hyg. 2023 Apr 17. doi: 10.1111/idh.12681. Online ahead of print.

ABSTRACT

OBJECTIVES: This cross-sectional study was to determine the coronavirus disease 2019 (COVID-19) vaccination intention of clinical dental hygienists in South Korea and the factors that influence vaccination intention.

METHODS: COVID-19 vaccination intention of the 500 participants was confirmed through a survey including the following options: ‘I will vaccinate (VAC)’, ‘I will not vaccinate (NoVAC)’ and ‘I do not know if I should get vaccinated (UNK)’. A Chi-square test was performed to determine whether there were differences in COVID-19 vaccination intention according to the general characteristics of the participants, degree of infection control knowledge (Score-K) and practice (Score-P) in response to COVID-19, fears over COVID-19 (Fear-C) and the level of anxiety before (GAD_Before ) and after (GAD_After ) the COVID-19 pandemic. Multiple logistic regression was performed to identify factors affecting VAC and NoVAC by setting the base category as UNK. The p-values of <0.05 were considered statistically significant.

RESULTS: According to the analysis, 44.8%, 18.8% and 36.4% of participants selected VAC, NoVAC and UNK respectively. There were significant differences in vaccination intention according to age, monthly income, residential area, symptoms related to COVID-19, Score-K, Fear-C and GAD_Before . Compared to UNK, < $2000 monthly income, Score-K and Fear-C variables significantly influenced the opinion of VAC. Compared to the answer UNK, monthly incomes of $2000 to $2360 and $2360 to $2730 in residential areas significantly influenced the opinion of NoVAC.

CONCLUSIONS: The variables influencing vaccination intention were monthly income, residential area, Score-K and Fear-C.

PMID:37066829 | DOI:10.1111/idh.12681

Aesthet Surg J. 2023 Apr 17:sjad100. doi: 10.1093/asj/sjad100. Online ahead of print.

ABSTRACT

BACKGROUND: Infraorbital hollowing can be addressed with hyaluronic acid soft tissue fillers. A prospective, multicenter, evaluator-blinded, randomized, controlled study (NCT03418545) demonstrated the safety and effectiveness of Juvéderm Volbella XC (VYC-15L, Allergan Aesthetics, an AbbVie company, Irvine, CA) in adults seeking correction for infraorbital hollows.

OBJECTIVE: The objective of the current analysis was to examine patient-reported outcomes (PROs) from the clinical study.

METHODS: Participants were randomized 3:1 to the VYC-15L treatment group or the no-treatment control group. Outcome measurements included: evaluating investigator (EI)- and participant-assessed Global Aesthetic Improvement Scale (GAIS) scores, as well as participant responses to the FACE-Q Appraisal of Lower Eyelids, questions on treatment satisfaction, the extent to which they were bothered by dark circles under their eyes, and willingness to recommend treatment to a friend.

RESULTS: The modified intent-to-treat population included 135 participants (median age, 47 years; 91.9% female). At Month 3, the majority of VYC-15L-treated participants showed improvements in the EI- and participant-assessed GAIS. The mean change from baseline to Month 3 score (32.7% increase) showed statistically significant improvement (mean: 17.8, SD: 19.8, p < 0.0001). At Months 3 and 12 post-treatment, most VYC-15L-treated participants reported feeling satisfied with treatment and not feeling moderately or very bothered by dark circles under their eyes, and would recommend treatment to a friend.

CONCLUSIONS: The current analysis demonstrated the effectiveness of VYC-15L treatment to reduce infraorbital hollowing and to improve overall satisfaction using validated PROs. Participant-assessed improvements aligned with EI-assessed outcomes and lasted through 1 year.

PMID:37066828 | DOI:10.1093/asj/sjad100

J Clin Endocrinol Metab. 2023 Apr 17:dgad212. doi: 10.1210/clinem/dgad212. Online ahead of print.

ABSTRACT

CONTEXT: The functional status of organs involved in IGF-1 signalling pathways such as the liver influence circulating levels of IGF-1 and hence its relationship with risk of chronic diseases and mortality, yet has received limited attention.

OBJECTIVE: To examine the relationship between IGF-1 and risk of morbidity and mortality from cancer, cardiovascular diseases and all-causes, accounting for liver function.

DESIGN: Case-cohort design nested within EPIC-Heidelberg. IGF-1 was measured in 7,461 stored serum samples collected from 1994 to 1998. Median follow-up for incident mortality events: 17.5 years.

SETTING: General community.

PARTICIPANTS: The case-cohort included a subcohort of 1,810 men and 1,890 women, in addition to 1668 incident cases of cancer (623 breast, 577 prostate, 202 lung and 268 colorectal cancers), and 1428 cases of CVD (707 MIs and 723 strokes) and 2441 cases of death.

RESULTS: Higher IGF-1 levels showed direct associations with risks of breast (1.25 95% CI: [1.06-1.47]) and prostate (1.31 [1.09-1.57]) cancers. Restricted cubic splines plots and models including IGF-1 as quintiles revealed a U-shaped relationship between the biomarker and mortality. Both participants with lowest and highest levels of IGF-1 experienced higher hazards of mortality from cancer, cardiovascular diseases and all-causes. The U-shaped form of the relationship persisted but was attenuated in analyses including only participants without any indications of liver dysfunction.

CONCLUSIONS: This large population-based prospective study showed that both individuals with lowest and highest levels of circulating IGF-1 were at increased risk of deaths from cancer, cardiovascular and all-causes. For individuals with low IGF-1, the excess risks of death were more pronounced among individuals with liver cancer and cirrhosis but were also present among individuals without elevated liver enzymes.

PMID:37066827 | DOI:10.1210/clinem/dgad212

Br J Radiol. 2023 Apr 17:20220889. doi: 10.1259/bjr.20220889. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the diagnostic accuracy of MRI-HSG with semiquantitative dynamic contrast-enhanced perfusion, against the virtual multi slice computed tomography hysterosalpingogram (VHSG) as a reference standard.

METHODS AND MATERIALS: In this prospective study, 26 women (age >18 years) searching for infertility causes and with VHSG physician request. Thereafter, the assessment performance of both techniques was determined by two reader analyses. k statistics were used for the assessment of tubal patency. Receiver operating characteristic (ROC) analysis was used to compare the capability for tubal patency assessment between both exams on a per-patient and per-tube basis. The McNemar test was used to compare the diagnostic accuracy measures.

RESULTS: Tubal patency, uterine morphological, ovarian, and extra uterine abnormalities were evaluated through both exams in all 26 women. There was no significant difference between diagnostic performance measurements between the methods. The ROC curve of VHSG was 0.852 for both per-patient and per-tube analyses, and one and 0.938 for MRI-HSG. Sensitivity and specificity for per-patient and per-tube for VHSG were 95.2 and 97.7, 80 and 87.5%, and for MRI-HSG 100% for both analyses and 100 and 87.5%, respectively.

CONCLUSION: This study demonstrates the feasibility of diagnosing tubal patency through MRI, using a semiquantitative dynamic contrast-enhanced perfusion sequence, and the satisfactory diagnosing of the uterine morphology, ovarian abnormalities, and ovarian and deep endometriosis.

ADVANCES IN KNOWLEDGE: Multiparametric MRI with a perfusion real-time sequence as a hysterosalpingography method can be used in the evaluation not only for uterine and ovarian abnormilities but also tubal patency.

PMID:37066809 | DOI:10.1259/bjr.20220889

J Am Heart Assoc. 2023 Apr 17:e028496. doi: 10.1161/JAHA.122.028496. Online ahead of print.

ABSTRACT

Background The incidences of atrial fibrillation (AF) and chronic kidney disease (CKD) are increasing, and AF is prevalent in patients with CKD. However, few studies have investigated the incidence or association of AF in a large CKD population from a longitudinal study. Methods and Results From a nationwide cohort, a total of 4 827 987 Korean individuals without prior AF, who received biennial health checkups provided by the National Health Insurance Service between 2009 and 2012 in Korea, were analyzed. Incidence of AF was ascertained through the end of 2018. During a median follow-up of 8.1 years, the annual incidence rate of AF was 1.17 per 1000 person-years among subjects without CKD, 1.55 for stage 1 CKD, 1.86 for stage 2 CKD, 2.1 for stage 3 CKD, and 4.33 for stage 4 CKD. In Fine-Gray regression models, CKD was associated with an increased risk of AF; the adjusted hazard ratios and 95% CIs of AF occurrence were 1.77 (1.69-1.85), 1.85 (1.80-1.91), 1.99 (1.95-2.04), and 4.04 (3.07-5.33) in individuals with CKD stages 1, 2, 3, and 4, respectively, compared with non-CKD. The association between CKD and incident AF remained statistically significant after adjustment for multiple confounding factors and was consistent across subgroups stratified by sex and age. Conclusions CKD is associated with an increased incidence of AF. Even mild CKD is associated with incident AF, and there was a stepwise increase in the risk of incident AF with a decrease in renal function.

PMID:37066806 | DOI:10.1161/JAHA.122.028496

Curr Rheumatol Rev. 2023 Apr 14. doi: 10.2174/1573397119666230414103624. Online ahead of print.

ABSTRACT

OBJECTIVE: This study was conducted to determine the association between gastroesophageal reflux disease (GERD) and rheumatoid arthritis (RA) by pooling the evidence from all available studies. Potentially eligible studies were identified from MEDLINE and EMBASE database from inception to April 2021 employing a search strategy that consisted of terms for “Rheumatoid Arthritis” and “Gastroesophageal Reflux Disease”. Eligible studies for the meta-analysis were recruited with conditions of being cohort studies that included rheumatoid arthritis and without rheumatoid arthritis individuals. Together with this, prevalence of GERD in both groups and the odds ratio (OR) comparing the prevalence of GERD between the two cohorts have been reported. The retrieved point estimates with standard errors from each study were pooled into the final result by the random-effect model and generic inverse variance method as described by DerSimonian and Laird.

RESULTS: A total of 3,646 articles were identified. After two rounds of independent review by two investigators, five cohort studies were included in the meta-analysis as they met the eligibility criteria. The pooled analysis demonstrated a significant association between RA and GERD with the pooled odds ratio of 1.98 (95% CI, 1.49 – 2.65). High statistical heterogeneity with I2 of 83% was observed. The funnel plot was symmetric and publication bias was not observed.

CONCLUSION: This systematic review and meta-analysis found a significant association between GERD and RA.

PMID:37066776 | DOI:10.2174/1573397119666230414103624