Category: Nevin Manimala

Cancer Med. 2023 Mar 7. doi: 10.1002/cam4.5702. Online ahead of print.

ABSTRACT

BACKGROUND: Hepatocellular carcinoma (HCC) is a common cancer threatening the public health globally. Although HCC has been associated with the telomere length (TL), the causal relationship between them is not well understood. Therefore, we attempted to explore the linear causal relationship between TL and HCC through Mendelian randomization (MR) analysis among Asian and European populations.

METHODS: The summary statistics of TL-associated single nucleotide polymorphisms (SNPs) were obtained from a genome-wide association study (GWAS) in the Asian population (N = 23,096). The data of TL-associated SNPs in the European population (N = 472,174) and the GWAS summary statistics of HCC in the Asian population (1866 cases, 195,745 controls) as well as the European population (168 cases, 372,016 controls) were downloaded from the public GWAS database. Two-sample MR was performed using inverse variance weighting (IVW), weighted median estimate, MR-Egger regression, weighted-mode estimate, and simple-mode estimate methods. Sensitivity analysis was performed to text the primary results’ robustness.

RESULTS: Nine SNPs associated with TL in Asian populations and 98 SNPs in European populations were selected as instrumental variables. No linear causal relationship between heritable TL and the HCC risk was recorded in the Asian (IVW analysis odds ratio [OR] = 1.023, 95% confidence interval [CI] 0.745, 1.405, p = 0.887) and European populations (IVW analysis OR = 0.487, 95% CI 0.180, 1.320, p = 0.157). Other methods also achieved similar outcomes. Sensitivity analysis was performed and revealed no heterogeneity and horizontal pleiotropy.

CONCLUSIONS: No linear causal association was recorded between heritable TL and HCC in Asian and European populations.

PMID:36880214 | DOI:10.1002/cam4.5702

Orbit. 2023 Mar 7:1-8. doi: 10.1080/01676830.2023.2186435. Online ahead of print.

ABSTRACT

PURPOSE: To assess whether transcutaneous retrobulbar amphotericin B injections (TRAMB) reduce exenteration rate without increasing mortality in rhino-orbital-cerebral mucormycosis (ROCM).

METHODS: In this retrospective case-control study, 46 patients (51 eyes) with biopsy-proven ROCM were evaluated at 9 tertiary care institutions from 1998 to 2021. Patients were stratified by radiographic evidence of local orbital versus extensive involvement at presentation. Extensive involvement was defined by MRI or CT evidence of abnormal or loss of contrast enhancement of the orbital apex with or without cavernous sinus, bilateral orbital, or intracranial extension. Cases (+TRAMB) received TRAMB as adjunctive therapy while controls (-TRAMB) did not. Patient survival, globe survival, and vision/motility loss were compared between +TRAMB and -TRAMB groups. A generalized linear mixed effects model including demographic and clinical covariates was used to evaluate the impact of TRAMB on orbital exenteration and disease-specific mortality.

RESULTS: Among eyes with local orbital involvement, exenteration was significantly lower in the +TRAMB group (1/8) versus -TRAMB (8/14) (p = 0.04). No significant difference in mortality was observed between the ±TRAMB groups. Among eyes with extensive involvement, there was no significant difference in exenteration or mortality rates between the ±TRAMB groups. Across all eyes, the number of TRAMB injections correlated with a statistically significant decreased rate of exenteration (p = 0.048); there was no correlation with mortality.

CONCLUSIONS: Patients with ROCM with local orbital involvement treated with adjunctive TRAMB demonstrated a lower exenteration rate and no increased risk of mortality. For extensive involvement, adjunctive TRAMB does not improve or worsen these outcomes.

PMID:36880205 | DOI:10.1080/01676830.2023.2186435

Public Health Nurs. 2023 Mar 6. doi: 10.1111/phn.13182. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore in a sample of school nurses (SN) in California the impact of the COVID-19 pandemic on school nurse health services, how school nurses mitigated the impact of COVID-19, and moral distress levels among school nurses.

DESIGN AND METHODS: Nineteen (N = 19) school nurses who work in K-12 schools in California, USA participated in a mixed-methods approach involving qualitative descriptive design, inductive content analysis, and descriptive statistics. Interviews were conducted in August and September 2021.

RESULTS: Five themes emerged: (1) role of the SN during the COVID-19 pandemic, (2) coordination with school administration, (3) COVID-19 related challenges and disruptions to care, (4) moral distress, and (5) coping during the pandemic.

CONCLUSION: The pandemic had a profound impact on school nurses. This study provides school nurse perspectives of the impact of COVID-19 on services they delivered, the unique skills of school nurses essential to mitigation strategies, and moral distress school nurses encountered during the pandemic. Understanding the important role school nurses had during the pandemic is paramount to fully contextualize the contributions they made within public health nursing practice and inform preparedness for future pandemics.

PMID:36880197 | DOI:10.1111/phn.13182

Ann Rehabil Med. 2023 Feb;47(1):4-10. doi: 10.5535/arm.23020. Epub 2023 Feb 28.

ABSTRACT

Spinal cord injury (SCI) has been recognized as a medically complex and life-disrupting condition. As the aging of the population accelerates, the trend of SCI has changed. This review aimed to provide comprehensive statistics and recent epidemiological changes in SCI and rehabilitation in Korea. All three insurance databases (National Health Insurance Service [NHIS], automobile insurance [AUI], and industrial accident compensation insurance [IACI]) were considered. These nationwide databases provide data on the current trends in term of incidence, etiology, and rehabilitation of SCI. Traumatic spinal cord injury (TSCI) was more frequent among the elderly in the NHIS compared to working age individuals in the AUI and IACI. In all three trauma-related insurance databases, male with TSCI outnumbered female. TSCI incidence per year was approximately 17 times higher among males than females, on average, in IACI. In all three insurances, the cervical level of TSCI was the most frequent. Although the ratio of SCI patients receiving rehabilitation treatment at primary and secondary hospitals increased for nine years, the increase in training on activities of daily living (ADL training) was found to be relatively small. This review provides a broader and comprehensive understanding of the incidence, etiology, and rehabilitation treatment of SCI in Korea.

PMID:36880194 | DOI:10.5535/arm.23020

Curr Radiopharm. 2023 Mar 7. doi: 10.2174/1874471016666230307113045. Online ahead of print.

ABSTRACT

OBJECTIVE: Previously, the 99mTc inhalation was used for pneumonia treatment that decreases inflammation and disease severity. We aimed to investigate the safety and effectiveness of carbon nanoparticles labeled with Technetium isotope (99mTc) in a form of ultradispersed aerosol in combination with standard COVID-19 therapy. The study was a randomized phase 1 and phase 2 clinical trial of low-dose radionuclide inhalation therapy for patients with COVID-19 related pneumonia.

METHOD: We enrolled 47 patients with confirmed COVID-19 infection and early laboratory signs of cytokine storm and randomized them into the Treatment and Control groups. We analyzed blood parameters reflecting the COVID-19 severity and inflammatory response.

RESULTS: Low-dose 99mTc-labeled inhalation showed a minimal accumulation of radionuclide in lungs in healthy volunteers. We observed no significant differences between the groups before treatment in WBC-count, D-dimer, CRP, Ferritin or LDH levels. We found that Ferritin and LDH levels significantly raised after the 7th day follow-up only in the Control group (p<0.0001 and p=0.0005, respectively), while mean values of the same indicators did not change in patients in the Treatment group after the radionuclide treatment. D-dimer values also lowered in the radionuclide treated group, however, this effect was not statistically significant. Furthermore, we evaluated a significant decrease in CD19+ cell counts in patients of the radionuclide-treated group.

CONCLUSION: Inhaled low-dose radionuclide therapy of 99mTc aerosol affects the major prognostic indicators of COVID-19-related pneumonia restraining inflammatory response. Overall, we identified no evidence of major adverse events in the group receiving radionuclide.

PMID:36880188 | DOI:10.2174/1874471016666230307113045

Res Synth Methods. 2023 Mar 6. doi: 10.1002/jrsm.1631. Online ahead of print.

ABSTRACT

Partial correlation coefficients are often used as effect sizes in the meta-analysis and systematic review of multiple regression analysis research results. There are two well-known formulas for the variance and thereby for the standard error (SE) of partial correlation coefficients (PCC). One is considered the ‘correct’ variance in the sense that it better reflects the variation of the sampling distribution of partial correlation coefficients. The second is used to test whether the population PCC is zero, and it reproduces the test statistics and the p-values of the original multiple regression coefficient that PCC is meant to represent. Simulations show that the ‘correct’ PCC variance causes random effects to be more biased than the alternative variance formula. Meta-analyses produced by this alternative formula statistically dominate those that use ‘correct’ SEs. Meta-analysts should never use the ‘correct’ formula for partial correlations’ standard errors. This article is protected by copyright. All rights reserved.

PMID:36880162 | DOI:10.1002/jrsm.1631

Kardiologiia. 2023 Feb 28;63(2):27-33. doi: 10.18087/cardio.2023.2.n1973.

ABSTRACT

Aim To study changes in cardiohemodynamic alterations of the myocardium and heart rhythm disorders at 3 and 6 months following the coronavirus infection.Material and methods EchoCG, ECG Holter monitoring, and Doppler ultrasonography of hepatolienal blood vessels were performed for 77 patients (mean age, 35.9 years) at 3 and 6 months after coronavirus infection. The patients were divided into the following groups: group 1, with injury of the upper respiratory tract; group 2, with bilateral pneumonia (CТ1, 2), and group 3, with severe pneumonia (CТ3, 4). Statistical analysis was performed with a SPSS Statistics Version 25.0 software package.Results At 6 months after the disease onset, the patients noted an improvement of their general condition. In patients with moderate pneumonia, early peak diastolic velocity (p=0.09), right ventricular isovolumic diastolic time (р=0.09), and pulmonary artery systolic pressure (р=0.005) where decreased, while tricuspid annular peak systolic velocity was, in contrast, increased (р=0.042). Both segmental systolic velocity of the LV mid-inferior segment (р=0.006) and the mitral annular Em / Am ratio were decreased. In patients with severe disease at 6 months, right atrial indexed volume was reduced (р=0.036), tricuspid annular Em / Am was decreased (р=0.046), portal and splenic vein flow velocities were decreased, and inferior vena cava diameter was reduced. Late diastolic transmitral flow velocity was increased (р=0.027), and LV basal inferolateral segmental systolic velocity was decreased (р=0.046). In all groups, the number of patients with heart rhythm disorders was decreased, and parasympathetic autonomic influences prevailed.Conclusion At 6 months after coronavirus infection, practically all patients noted improvement of their general condition; incidence rate of arrhythmia and cases of pericardial effusion were decreased; and autonomic nervous system activity recovered. In patients with moderate and severe disease, morpho-functional parameters of the right heart and the hepatolienal blood flow were normalized, however, occult disorders of LV diastolic function remained, and LV segmental systolic velocity was reduced.

PMID:36880140 | DOI:10.18087/cardio.2023.2.n1973

Phytochem Anal. 2023 Mar 6. doi: 10.1002/pca.3220. Online ahead of print.

ABSTRACT

INTRODUCTION: Moringa oleifera is a plant with high antioxidant content in its leaves, flowers and seeds. It attracts the attention of researchers with the effect of its nutritional and medical advantages.

OBJECTIVE: The purpose of the current study is to propose a deep eutectic solvent (DES)-based ultrasound-assisted extraction of bioactive substances from M. oleifera leaves by the application of a chemometric study.

METHODOLOGY: A total of 18 different choline chloride-based DESs were prepared by using several hydrogen bond donors (glucose, sucrose, glycerol, ethylene glycol, urea and dimethyl urea) with various molar ratios (1:1, 1:2 and 2:1) by addition of diluents (water and 50% methanol) or alone. In order to decide the best DES combination, principal component analysis (PCA) was applied. The response surface method (RSM) was used as statistical experimental design approach through the Box-Behnken design.

RESULTS: The best phenolic (TPC), flavonoid (TFC) and antioxidant activity yields of M. oleifera leaf extract were found to be 19.102 mg-GAE, 10.47 mg-CE and 24.404 mg-TEAC per gram dried leaf under the optimal conditions (50% water content, 20% amplitude, 15 min time). The model fitting has been also found reliable depending on the statistical indicators such as p-value (<0.0001), coefficients of determination (R² = 0.9827, 0.9916 and 0.9864) and root mean square error (RMSE = 1.0562, 2.4656 and 0.7713).

CONCLUSIONS: A chemometric study through PCA was carried out to determine the similarities and differences between the solvent groups, and the ethylene glycol-based DES (1:2, molar ratio) with the addition of water showed the best performance.

PMID:36880135 | DOI:10.1002/pca.3220

Physiother Res Int. 2023 Mar 6:e1997. doi: 10.1002/pri.1997. Online ahead of print.

ABSTRACT

OBJECTIVE: Mirror therapy (MT) has been proposed to be an effective therapeutic regimen for lower limb stroke rehabilitation. This review is the first to evaluate the efficacy of MT in subacute and chronic stroke for lower-limb motor functions, balance and gait focusing on particular stage of stroke with specific outcome measures.

METHODS: According to PRISMA guidelines, all relevant sources were searched from 2005 to 2020 using “PIOD” framework. Search methods included electronic database, hand and citation searching. Screening and quality assessment was performed by two individual reviewers. Data was extracted and synthesised from 10 studies. Thematic analysis was considered, random-effect models were used and pooled analysis was performed using forest plots.

RESULTS: For motor recovery, MT showed statistically significant effects compared to control group using Fugl-Meyer Assessment and Brunnstorm stages as outcome measures (SMD 0.59; 95% CI 0.29 to 0.88; p < 0.0001; I² = 0%). Statistical significant improvement was reported for balance in MT compared to control using Berg Balance Scale and Biodex in pooled analysis (SMD 0.47; 95% CI 0.04 to 0.90; p = 0.03; I² = 0%). When compared with electric stimulation and action-observation training MT showed no signifiant improvement for balance (SMD -0.21; 95% CI -0.91 to 0.50; p = 0.56; I² = 39%). For gait, MT showed statistical and clinical significant improvement compared to control group (SMD 1.13; 95% CI 0.27-2.00; p = 0.01; I² = 84%) and when compared to action-observation training and electrical stimulation, presented statistical improvement using 10-m walk test and Motion Capture system (SMD -0.65; 95% CI -1.15 to -0.15; p = 0.01; I² = 0%).

CONCLUSION: This review has shown that MT is effective in lower-limb motor recovery, balance and gait in subacute and chronic stroke in patients 18 years or above with no severe cognitive disorder, MMSE score ≥24 and FAC level ≥2. MT could be used for 30 min/day, 5 days/week for 4 weeks, as stand-alone for motor recovery and balance or as an adjunct with electric stimulation for gait for beneficial effects.

PMID:36880119 | DOI:10.1002/pri.1997

Cancer Med. 2023 Mar 6. doi: 10.1002/cam4.5613. Online ahead of print.

ABSTRACT

AIM: To evaluate the role of Sonazoid enhanced ultrasound assistant laparoscopic radiofrequency ablation in treating liver malignancy.

METHODS: Consecutive patients are recruited. Rates of complication and postoperative length of stay are compared between the study and control groups. Progression-free survival (PFS) of colorectal liver metastasis (CRLM) after ablation are compared. Complete ablation rates are compared and optimal tumor size is calculated by ROC curve analysis. Risk factors of incomplete ablation are determined by logistic regression analysis.

RESULTS: Totally 73 patients with 153 lesions were included. No significant differences in the rate of complication were found between the study and control groups. PFS of CRLM in laparoscopic, intraoperative CEUS, and laparoscopic CEUS groups are all longer than their control groups. Complete ablation rates of laparoscopic, intraoperative CEUS, and laparoscopic CEUS groups are all higher than in their control groups with statistical significance. A tumor size of 2.15 cm is determined to be the optimal cut-off with the area under the ROC curve of 0.854, 95% CI (0.764, 0.944), p = 0.001. In logistic regression analysis, tumor size [OR 20.425, 95% CI (3.136, 133.045), p = 0.002] and location of segments VII and VIII [OR 9.433, 95% CI (1.364, 65.223), p = 0.023] are calculated to be the risk factors of incomplete ablation, meanwhile, intraoperative CEUS shows to be a protective factor in univariate analysis [OR 0.110, 95% CI (0.013, 0.915), p = 0.041].

CONCLUSION: Sonazoid-enhanced ultrasound assistant laparoscopic radiofrequency ablation is safe and effective to treat liver malignancy. We should pay attention to the ablation planning of larger tumors and tumors in special locations.

PMID:36880113 | DOI:10.1002/cam4.5613