Category: Nevin Manimala

Endoscopy. 2023 Mar 21. doi: 10.1055/a-2040-4042. Online ahead of print.

ABSTRACT

BACKGROUND : Endoscopic full-thickness plication (EFTP) has shown promising results in gastroesophageal reflux disease (GERD), but its efficacy in GERD after peroral endoscopic myotomy (POEM) is unclear. METHODS : In a prospective, randomized trial of post-POEM patients dependent on proton pump inhibitors (PPIs) for documented GERD, patients underwent EFTP (plication to remodel the gastroesophageal flap valve) or an endoscopic sham procedure (positioning of the EFTP device, but no stapling). The primary end point was improvement in acid exposure time (AET) < 6 % (3 months). Secondary end points included improvement in esophagitis (3 months), GERD Questionnaire (GERDQ) score (3 and 6 months), and PPI usage (6 months). RESULTS : 60 patients were randomized (30 in each group). At 3 months, a significantly higher proportion of patients achieved improvement in AET < 6 % in the EFTP group compared with the sham group (69.0 % [95 %CI 52.1-85.8] vs. 10.3 % [95 %CI 0-21.4], respectively). EFTP was statistically superior to sham (within-group analysis) in improving esophageal AET, DeMeester Score, and all reflux episodes (P < 0.001). A nonsignificant improvement in esophagitis was noted in the EFTP group (P = 0.14). Median GERDQ scores (3 months) were significantly better (P < 0.001) in the EFTP group, and the same trend continued at 6 months. A higher proportion of patients in the sham group continued to use PPIs (72.4 % [95 %CI 56.1-88.7] vs. 27.6 % [95 %CI 11.3-43.8]). There were no major adverse events in either group. CONCLUSION : EFTP improved post-POEM GERD symptoms, 24-hour pH impedance findings with normalization in one-third, and reduced PPI usage at 6 months.

PMID:36944359 | DOI:10.1055/a-2040-4042

Osong Public Health Res Perspect. 2023 Feb;14(1):59-65. doi: 10.24171/j.phrp.2022.0293. Epub 2023 Feb 1.

ABSTRACT

OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has continued since its first detection in the Republic of Korea on January 20, 2020. This study describes the early countermeasures used to minimize the risk of COVID-19 outbreaks during cohort quarantine and compares the epidemiological characteristics of 2 outbreaks in long-term care facilities (LTCFs) in Gwangju Metropolitan City in summer 2020.

METHODS: An epidemiological investigation was conducted via direct visits. We investigated epidemiological characteristics, including incidence, morbidity, and mortality rates, for all residents and staff members. Demographic characteristics were analyzed using a statistical program. Additionally, the method of managing infection in LTCFs is described.

RESULTS: Residents and caregivers had high incidence rates in LTCF-A and LTCF-B, respectively. LTCF-B had a longer quarantine period than LTCF-A. The attack rate was 20.02% in LTCF-A and 27.9% in LTCF-B. The mortality rate was 2.3% (1/43) in LTCF-B, the only facility in which a COVID-19 death occurred.

CONCLUSIONS: Extensive management requires contact minimization, which involves testing all contacts to mitigate further transmission in the early stages of LTCF outbreaks. The findings of this study can help inform and prepare public health authorities for COVID-19 outbreaks, particularly for early control in vulnerable facilities.

PMID:36944346 | DOI:10.24171/j.phrp.2022.0293

Cell Stem Cell. 2023 Mar 11:S1934-5909(23)00069-3. doi: 10.1016/j.stem.2023.02.008. Online ahead of print.

ABSTRACT

We recently demonstrated the chemical reprogramming of human somatic cells to pluripotent stem cells (hCiPSCs), which provides a robust approach for cell fate manipulation. However, the utility of this chemical approach is currently hampered by slow kinetics. Here, by screening for small molecule boosters and systematically optimizing the original condition, we have established a robust, chemically defined reprogramming protocol, which greatly shortens the induction time from ∼50 days to a minimum of 16 days and enables highly reproducible and efficient generation of hCiPSCs from all 17 tested donors. We found that this optimized protocol enabled a more direct reprogramming process by promoting cell proliferation and oxidative phosphorylation metabolic activities at the early stage. Our results highlight a distinct chemical reprogramming pathway that leads to a shortcut for the generation of human pluripotent stem cells, which represents a powerful strategy for human cell fate manipulation.

PMID:36944335 | DOI:10.1016/j.stem.2023.02.008

Hum Hered. 2023 Mar 21. doi: 10.1159/000530112. Online ahead of print.

ABSTRACT

INTRODUCTION: We have reported that high total homocysteine (tHCY), and the coexistence of inadequate thyroid hormones in maternal serum increase the risk of fetal neural tube defects (NTDs). Placental iodothyronine deiodinases (DIOs: DIO1, DIO2, and DIO3) play a role in regulate the conversions between different forms of maternal thyroid hormones. This study hypothesized that single nucleotide polymorphisms (SNPs) in placental DIOs genes could be related to NTDs.

METHODS: We performed a case-control study from 2007 to 2009 that included pregnant women from Lüliang, Shanxi Province, China. Nine distinct SNPs in DIOs genes were analyzed and placental samples were obtained from 83 pregnant women with NTDs fetuses and 90 pregnant women with normal fetuses. The nine SNPs were analyzed using the Cochran-Armitage test and the Fisher’s exact test.

RESULTS: There were no statistically significant differences between case and control in the nine SNPs of DIOs (P>0.05).

CONCLUSIONS: The results of this study suggested that SNPs of DIOs genes in placenta among pregnant women has no statistically significant difference between the two groups, suggesting that other factors might be involved in metabolism of maternal thyroid hormone provided to fetuses, such as epigenetic modification of methylation and homocysteinylation and genomic imprinting in the placenta. Further those functional studies on placenta samples are necessary.

PMID:36944328 | DOI:10.1159/000530112

Dermatology. 2023 Mar 21. doi: 10.1159/000530121. Online ahead of print.

ABSTRACT

BACKGROUND: Pemphigus vulgaris is a life-threatening autoimmune bullous disease characterized by flaccid blister formation. As there has been no macroscopic assessment of epidemiological characteristics, its disease burden in the general population remains unknown.

OBJECTIVES: To assess the global incidence rate of pemphigus vulgaris in the general population.

METHODS: The search was conducted in databases including Medline, Embase, Web of Science, and The Cochrane Library from inception to May 1st, 2022. We included original studies that either reported incidence of pemphigus vulgaris or provided raw data for calculating. Studies based on a specific population instead of the general population were excluded. Individual studies were summarized using random-effects mode. The pooled incidence rate of pemphigus vulgaris among the general population and subgroups were obtained. Heterogeneity (I2 statistic) was assessed with the χ2 test on Cochrane’s Q statistic.

RESULTS: 29 studies were eligible for final analysis and the pooled incidence rate of pemphigus vulgaris was 2.83 per million person-years (95%CI, 2.14-3.61). The incidence rate was similar between men and women and remained stable in the past half-century. Southern Asia showed the highest rate among subcontinents that had more than one study conducted as 4.94 per million person-years (95%CI, 2.55-8.10). Economic levels do not seem to have any bearing on incidence.

CONCLUSIONS: Despite the substantial heterogeneity among studies, this meta-analysis revealed the worldwide incidence rate of pemphigus vulgaris for the first time and may assist in assessing global disease burden and promoting health policy.

PMID:36944327 | DOI:10.1159/000530121

Urol Int. 2023 Mar 21:1-6. doi: 10.1159/000529688. Online ahead of print.

ABSTRACT

INTRODUCTION: The aim of the study was to investigate the effect of the diameter of the ureteral access sheath (UAS) used during RIRS on kidney injury based on acute kidney injury (AKI) biomarkers.

METHODS: This prospectively randomized controlled study included a total of 125 patients divided into three groups: group 1 (n = 52) in which a 12/14 Fr UAS was used, group 2 (n = 52) in which a 9.5/11.5 Fr UAS was used, and group 3 (n = 21) that was designed as the control group with no urogenital disease history. Urine samples were collected preoperatively and at the postoperative second and 24th hours after surgery and analyzed for AKI using the urinary kidney injury molecule-1 (uKIM-1), N-acetyl-ß-D-glucosaminidase, and neutrophil gelatinase-associated lipocain biomarkers.

RESULTS: In group 1, there was no statistical change in any of the three AKI biomarkers at the postoperative second or 24th hour compared to the preoperative period. In group 2, the values of all three AKI biomarkers were statistically significantly increased at the postoperative second and 24th hours compared to the preoperative period while no statistical difference was observed between the two postoperative evaluation times. At the postoperative second hour, the uKIM-1 value was statistically significantly higher in group 2 compared to group 1 (p = 0.043).

CONCLUSIONS: The results of our study showed that AKI was not observed in RIRS performed with a 12/14 Fr UAS while the use of a 9.5/11.5 Fr UAS resulted in AKI according to the assessment of the related biomarkers.

PMID:36944319 | DOI:10.1159/000529688

J Biomech. 2023 Mar 17;151:111548. doi: 10.1016/j.jbiomech.2023.111548. Online ahead of print.

ABSTRACT

Measuring and predicting accurate joint angles are important to developing analytical tools to gauge users’ progress. Such measurement is usually performed in laboratory settings, which is difficult and expensive. So, the aim of this study was continuous estimation of lower limb joint angles during walking using an accelerometer and random forest (RF). Thus, 73 subjects (26 women and 47 men) voluntarily participated in this study. The subjects walked at the slow, moderate, and fast speeds on a walkway, which was covered with 10 Vicon camera. Acceleration was used as input for a RF to estimate ankle, knee, and hip angles (in transverse, frontal, and sagittal planes). Pearson correlation coefficient (r) and Mean Square Error (MSE) were computed between the experimental and estimated data. Paired statistical parametric mapping (SPM) t-test was used to compare the experimental and estimated data throughout gait cycle. The results of this study showed that the MSE of joint angles between the experimental and estimated data ranged from 0.04 to 24.29 and r > 0.91. Moreover, the findings of SPM indicated that there was no significant difference between the experimental and estimated data of ankle, knee, and hip angles in all three planes throughout gait cycle. The results of our research developed a more accessible, portable procedure to quantifying lower limb joint angles by an accelerometer and RF. So, such wearable-based joint angles have the potential to be used in outside-laboratory settings to measure walking kinematics.

PMID:36944294 | DOI:10.1016/j.jbiomech.2023.111548

Clin Nutr. 2023 Mar 14;42(5):670-686. doi: 10.1016/j.clnu.2023.03.009. Online ahead of print.

ABSTRACT

BACKGROUND: The growing incidence of cancer globally, and the importance of nutrition support for these patients, emphasize the need for the development of nutritional clinical practice guidelines and consensus papers (CPGs) in the field. Numerous relevant CPGs have been published by several organizations worldwide. The aim of this systematic review was to compare the content of the existing CPGs and evaluate the quality of their development using the AGREE-II tool.

METHODS: A systematic literature search in PubMed, Embase and Web of Science databases was conducted for the identification of relevant CPGs and consensus papers. Eligible CPGs was blindly evaluated by four appraisers according to the Appraisal of Guidelines for Research and Evaluation ΙΙ (AGREE-II) tool.

RESULTS: In total 15 CPGs were identified and were evaluated. All but one set of CPGs underlined the importance of nutritional screening and assessment, whereas recommendations on nutritional interventions, supplements, management of complications and nutritional follow-up were also reported by several organizations. AGREE-II results showed that two CPGs were characterized as high, eight as moderate and five as low regarding their quality of development.

CONCLUSIONS: Variety on recommendations could be observed between CPGs that should be considered when applied into clinical practice. Limitations of the existing CPGs could be the fact that they are non-specific and only a minority of them are focused to specific cancer types. Frequent updates for CPGs and inclusion of more nutritional topics should be considered for some CPGs. Improvement of the quality of the CPGs development should also be pursued in future.

PMID:36944289 | DOI:10.1016/j.clnu.2023.03.009

Adv Med Sci. 2023 Mar 19;68(1):138-146. doi: 10.1016/j.advms.2023.02.005. Online ahead of print.

ABSTRACT

PURPOSE: Multimodal treatment is the standard of care in patients with locally advanced gastric cancer. Unfortunately, the response rate after neoadjuvant treatment remains limited. The ability to predict the response has a potential to improve patient outcomes by promoting a more individualized approach. We sought to describe the current state of research in pre-treatment molecular biomarkers of response to neoadjuvant therapy in gastric adenocarcinoma available for testing before the initiation of treatment and to perform a systematic review and meta-analysis in order to summarize and evaluate the potential methods.

METHODS: A systematic MEDLINE, EMBASE and CENTRAL literature search was conducted to extract articles on potentially predictive molecular biomarkers of pathological response to neoadjuvant therapy in patients with gastric- and esophago-gastric junction adenocarcinoma. Fixed and random effects models were used to undertake the meta-analysis when appropriate.

RESULTS: Data on predictive biomarkers was reported in 38 studies. These articles described 47 biomarkers showing statistical significance. After evaluation of all reported biomarkers, 3 of them met the inclusion criteria for meta-analysis. The meta-analysis results indicate that >5 ​ng/mL pre-therapeutic serum concentration of carcinoembryonic antigen (CEA; norm <5 ​ng/mL) is significantly associated with tumor response (RR ​= ​5.13, 95% CI 2.53-10.43, P ​= ​0.026).

CONCLUSION: Previous studies describe a large number of candidate biomarkers. Our meta-analysis indicated pre-therapeutic serum concentration of CEA >5 ​ng/mL as a potential and easy-accessible biomarker available for use before initiation of treatment. However, it could be only an additional tool for complex qualification for neoadjuvant therapy.

PMID:36944288 | DOI:10.1016/j.advms.2023.02.005

Comput Methods Programs Biomed. 2023 Jan 18;233:107360. doi: 10.1016/j.cmpb.2023.107360. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: The aim of this study is to solve the non-stationarity and complexity characteristics and huge individual differences in the electroencephalogram (EEG) signals for depression classification.

METHODS: To address those problems, the Lempel-Ziv complexity feature matrices were extracted from the EEG signals under the two paradigms of eyes open and eyes closed in the resting state. Topographical map of brain and statistical analysis were introduced to investigate the significance of eyes open and eyes closed EEG for depression classification. To promote the classification accuracy, feature matrices from the two paradigms were fused. And linear combination and concatenation fusion methods were proposed to further reveal the underlying mechanism of improving classification accuracy. Support vector machine (SVM), K-nearest neighbor, and decision tree classifiers were employed and compared to classify depression under the eyes open, eyes closed and fused paradigm.

RESULTS: The classification results of 10-fold cross-validation showed that the highest average accuracy (86.58%) under a single paradigm was achieved in the eyes-open state. The multiparadigm fusion method of concatenation was better than the linear combination. The best classification result was obtained using multiparadigm feature concatenation under the SVM classifier, yielding an accuracy of 94.03%.

CONCLUSION: The multiparadigm feature fusion method proposed in this paper can effectively improve the accuracy of depression classification. It was proved that eyes open and eyes closed EEG have complementary information, which was benefit for the cross-subject classification of depression. It provides new ideas for depression classification in clinics.

PMID:36944276 | DOI:10.1016/j.cmpb.2023.107360