Category: Nevin Manimala

J Cancer Res Clin Oncol. 2022 Oct 15. doi: 10.1007/s00432-022-04327-0. Online ahead of print.

ABSTRACT

INTRODUCTION: Despite comparatively favourable prognosis in polycythemia vera (PV) patients (pts), the overall survival is shorter compared to the age-matched general population. The aim of the study was to evaluate the impact of chosen laboratory and genetic factors on the individual disease outcome, i.e. risk of thrombosis, myelofibrosis/blastic transformation and death.

MATERIALS AND METHODS: The study group consisted of 151 pts and 57 healthy donors (HD).

RESULTS: JAK2V617F mutation was found in 96.7% (146/151) of the studied pts. JAK2 exon 12 mutations were identified in 2 individuals. The coexistence of JAK2V617F and JAK2 exon 12 mutation was confirmed in 2 other pts. In one case, neither JAK2V617F nor JAK2 exon 12 mutation was found. The presence of ten different non-driver mutations (ASXL1, SRSF2, U2AF1, IDH2) in eight of the analyzed pts (5.3%) was confirmed. The overall frequency of thrombotic events (TE) in the studied PV group was 23.8% (36/151). In patients with TE, median platelet count was lower than in pts without TE. Thrombotic risk did not depend on JAK2 rs12343867, TERT rs2736100, OBFC1 rs9420907 SNV, however, we found a novel strong tendency towards statistical significance between the CC genotype miR-146a rs2431697 and thrombosis. The disease progression to fibrotic phase was confirmed in 9% of the pts. Fibrotic transformation in PV pts was affected mainly by JAK2V617F variant allele frequency (VAF) and the presence of coexisting non-driver variants. The high JAK2V617F VAF and elevated white blood cell (WBC) count at the time of diagnosis were associated with an increased risk of death.

CONCLUSION: Therefore, in our opinion, complex, laboratory and genetic PV pts evaluation at the time of diagnosis should be incorporated into a new prognostic scoring system to more precisely define the PV prognosis and to optimize the therapeutic decision-making process.

PMID:36242602 | DOI:10.1007/s00432-022-04327-0

Trop Anim Health Prod. 2022 Oct 15;54(6):345. doi: 10.1007/s11250-022-03329-x.

ABSTRACT

The incorporation of novel technologies such as artificial intelligence, data mining, and advanced statistical methodologies have received wide responses from researchers. This study was designed to model the factors impacting the actual milk yield of Holstein-Friesian cows using the proportional odds ordered logit model (OLM). A total of 8300 lactation records were collected for cows calved between 2005 and 2019. The actual milk yield, the outcome variable, was categorized into three levels: low (< 4500 kg), medium (4500-7500 kg), and high (> 7500 kg). The studied predictor variables were age at first calving (AFC), lactation order (LO), days open (DO), lactation period (LP), peak milk yield (PMY), and dry period (DP). The proportionality assumption of odds using the logit link function was verified for the current datasets. The goodness-of-fit measures revealed the suitability of the ordered logit models to datasets structure. Results showed that cows with younger ages at first calving produce two times higher milk quantities. Also, longer days open were associated with higher milk yield. The highest amount of milk yield was denoted by higher lactation periods (> 250 days). The peak yield per kg was significantly related to the actual yield (P < 0.05). Moreover, shorter dry periods showed about 1.5 times higher milk yield. The greatest yield was observed in the 2nd and 4th parities, with an odds ratio (OR) equal to 1.75, on average. In conclusion, OLM can be used for analyzing dairy cows’ data, denoting fruitful information as compared to the other classical regression models. In addition, the current study showed the possibility and applicability of OLM in understanding and analyzing livestock datasets suited for planning effective breeding programs.

PMID:36242599 | DOI:10.1007/s11250-022-03329-x

J Manag Care Spec Pharm. 2022 Nov;28(11-a Suppl):S2-S13. doi: 10.18553/jmcp.2022.28.11-a.s1.

ABSTRACT

BACKGROUND: The prevalence of major depressive disorder (MDD) continues to rise year over year, resulting in significant economic implications. However, when patients are treated with contemporary standard-of-care antidepressant pharmacotherapies, a suboptimal response is often attained, resulting in frequent treatment changes. OBJECTIVE: To compare health care resource utilization (HCRU) and all-cause medical and pharmacy costs between commercially insured patients with an MDD diagnosis and matched non-MDD patients and explore treatment patterns among patients with MDD initiating antidepressant pharmacotherapy. METHODS: This was a retrospective, observational analysis of IBM MarketScan US commercial claims data. Adults aged 18 years and older with continuous enrollment 12 or more months before and after the patient’s first MDD diagnosis from 2017 to 2018 were included in the analysis. HCRU and all-cause medical and pharmacy costs were compared among patients with MDD and a 1:1 exact-matched cohort of non-MDD patients during the same period (Objective 1). Treatment patterns (persistence, discontinuation, switch, combination, and augmentation) were analyzed for patients with MDD starting first-line antidepressant monotherapy for up to 12 months following their antidepressant initiation index date (Objective 2). Time to first treatment change or discontinuation was calculated and treatment patterns were graphically displayed in Sankey diagrams. RESULTS: 625,272 patients with MDD were matched 1:1 to a cohort of non-MDD patients in Objective 1. Patients with MDD had statistically significantly greater all-cause medical (20.4 vs 9.4; P < 0.0001), outpatient (19.5 vs 9.0; P < 0.0001), emergency department (0.51 vs 0.23; P < 0.0001), inpatient (0.35 vs 0.11; P < 0.0001), and any mental health-related (7.7 vs 0.58; P < 0.0001) visits compared with non-MDD patients. Mean all-cause medical costs were $6,809 (P < 0.0001) higher among patients with MDD than among patients without MDD ($13,183 vs $6,374, respectively). In Objective 2, 44,485 patients with MDD who received antidepressant monotherapy as their first-line MDD treatment were examined. Among the first treatment patterns observed following initiation, 19.3% of patients persisted with their first-line therapy, 56.2% discontinued antidepressant therapy, 24.5% experienced a treatment change (switching, adding a second antidepressant, or augmenting their existing therapy). The median days until first treatment change were 65 days for those discontinuing and 47 days for those switching antidepressants. Among the 24.5% of patients with a treatment change, 50.0% experienced another change in therapy within 30 days. CONCLUSIONS: The HCRU and costs accrued for patients with MDD is significantly greater than those for non-MDD patients. A large proportion of patients with MDD experienced treatment changes shortly after initiating their first-line antidepressant therapy. The results of this study highlight the need for reevaluation of the current MDD treatment paradigm. DISCLOSURES: Drs Zhu and Namjoshi are employees of Biogen Inc. and may hold stock. Dr Ferries and Ms Suthoff are employees of Sage Therapeutics, Inc., and may hold stock and/or stock options. Dr Bera has no potential conflicts of interest to disclose. This research was funded by Sage Therapeutics and Biogen. Manuscript editorial services were provided by Boston Strategic Partners, Inc., funded by Sage Therapeutics and Biogen. This work was supported by Sage Therapeutics, Inc., and Biogen. The authors had full editorial control of the manuscript and provided final approval on all content.

PMID:36242598 | DOI:10.18553/jmcp.2022.28.11-a.s1

Brief Bioinform. 2022 Oct 14:bbac449. doi: 10.1093/bib/bbac449. Online ahead of print.

ABSTRACT

We performed systematic assessment of computational deconvolution methods that play an important role in the estimation of cell type proportions from bulk methylation data. The proposed framework methylDeConv (available as an R package) integrates several deconvolution methods for methylation profiles (Illumina HumanMethylation450 and MethylationEPIC arrays) and offers different cell-type-specific CpG selection to construct the extended reference library which incorporates the main immune cell subsets, epithelial cells and cell-free DNAs. We compared the performance of different deconvolution algorithms via simulations and benchmark datasets and further investigated the associations of the estimated cell type proportions to cancer therapy in breast cancer and subtypes in melanoma methylation case studies. Our results indicated that the deconvolution based on the extended reference library is critical to obtain accurate estimates of cell proportions in non-blood tissues.

PMID:36242584 | DOI:10.1093/bib/bbac449

J Neurosurg Pediatr. 2022 Oct 14:1-8. doi: 10.3171/2022.9.PEDS22344. Online ahead of print.

ABSTRACT

OBJECTIVE: Resection and disconnection surgeries for epilepsy in the pediatric demographic (patients ≤ 18 years of age) are two separate, definitive intervention options in medically refractory cases. Questions remain regarding the role of surgery when seizures persist after an initial incomplete surgery. The aim of this study was to review the contemporary literature and summarize the metadata on the outcomes of repeat surgery in this specific demographic.

METHODS: Searches of seven electronic databases from inception to July 2022 were conducted using PRISMA guidelines. Articles were screened using prespecified criteria. Metadata from the articles were abstracted and pooled by random-effects meta-analysis of proportions.

RESULTS: Eleven studies describing 12 cohorts satisfied all criteria, reporting outcomes of 170 pediatric patients with epilepsy who underwent repeat resection or disconnection surgery. Of these patients, 55% were male, and across all studies, median ages at initial and repeat surgeries were 7.2 and 9.4 years, respectively. The median follow-up duration after repeat surgery was 47.7 months. The most commonly reported etiology for epilepsy was cortical dysplasia. Overall, the estimated incidence of complete seizure freedom (Engel class I) following repeat surgery was 48% (95% CI 40%-56%, p value for heterogeneity = 0.93), and the estimated incidence of postoperative complications following repeat surgery was 25% (95% CI 12%-39%, p = 0.04). There were six cohorts each that described outcomes for repeat resection and repeat disconnection surgeries. There was no statistical difference between these two subgroups with respect to estimated incidence of complete seizure freedom (p value for interaction = 0.92), but postoperative complications were statistically more common following repeat resection (p ≤ 0.01).

CONCLUSIONS: For both resection and disconnection surgeries, repeat epilepsy surgery in children is likely to confer complete seizure freedom in approximately half of the patients who experience unsuccessful initial incomplete epilepsy surgery. More data are needed to elucidate the impact on efficacy based on surgical approach selection. Judicious discussion and planning between the patient, family, and a multidisciplinary team of epilepsy specialists is recommended to optimize expectations and outcomes in this setting.

PMID:36242580 | DOI:10.3171/2022.9.PEDS22344

Mil Med. 2022 Oct 15:usac311. doi: 10.1093/milmed/usac311. Online ahead of print.

ABSTRACT

INTRODUCTION: U.S. military pilots are required to meet certain medical standards in order to maintain an active flying status. Military pilots face potential temporary or permanent loss of flying privileges in the setting of a new condition or symptom that does not meet required standards, which could result in negative social and occupational repercussions for the pilot. For this reason, it has been proposed that U.S. military pilots participate in health care avoidance behavior, but little evidence exists to characterize such a trend in this population.

MATERIALS AND METHODS: We conducted a non-probabilistic Internet survey of the general population of U.S. pilots from November 1, 2019 through August 1, 2021. The current study is a sub-analysis of military pilots.

RESULTS: A total of 4,320 pilots answered the informed consent question, and 264 selected one military pilot type and were included in this sub-analysis. There were 72% of military pilots who reported a history of health care avoidance behavior (n = 190), and no statistical difference was found between age groups, gender, and military pilot types. There were 55.5% of pilots who reported a history of seeking informal medical care (n = 147), 33.7% of pilots who have flown despite a new symptom they felt required medical evaluation, 42.5% of pilots who reported withholding information on aeromedical screening (n = 111), and 11.4% of pilots who reported a history of undisclosed prescription medication use (n = 30).

CONCLUSIONS: U.S. military pilots may participate in health care avoidance behavior because of fear for loss of flying status.

PMID:36242520 | DOI:10.1093/milmed/usac311

Soc Work Public Health. 2022 Oct 15:1-11. doi: 10.1080/19371918.2022.2134249. Online ahead of print.

ABSTRACT

The purpose of this study was to examine the impact of socioeconomic factors on fruit and vegetable consumption in the households of Pakistan. Secondary data were used from a national-level survey, i.e. “Household Integrated Income and Consumption Survey” (HIICS) 2015-2016 published by the Pakistan Bureau of Statistics. A total of 11,187 households were included in the final analysis. Quantile regression models were applied to investigate the association between socioeconomic factors and the consumption of fruit and vegetable. More than half of the households in the sample did not meet the World Health Organization’s (WHO) recommended criteria for fruit and vegetable consumption, which is 400 g/day/capita. According to the quantile regression model, household income is an important factor in increasing fruit and vegetable intake because an increase in income leads to a greater likelihood of spending on healthy and nutritious foods. The increased consumption of fruit and vegetable was caused by the household head’s high education, which created multiple resources to increase income. Households in two provinces, i.e. Khyber Pakhtunkhwa and Baluchistan, have a greater impact on fruit and vegetable consumption than other provinces due to natural resource availability. Household size and dependency ratio hurt the consumption of fruit and vegetable because women and children are not able to do work. These results are very useful because a better understanding of the socioeconomic characteristics associated with fruit and vegetable intake could improve the effectiveness of policies aimed at increasing fruit and vegetable consumption and reducing the risk of chronic diseases.

PMID:36242534 | DOI:10.1080/19371918.2022.2134249

J Pharm Pract. 2022 Oct 14:8971900221134642. doi: 10.1177/08971900221134642. Online ahead of print.

ABSTRACT

Introduction: Pursuant to the COVID-19 pandemic, an executive order issued by the New York State (NYS) governor allowed pharmacists to act as laboratory directors for a limited-service laboratory (LSL) to order and perform Food and Drug Administration (FDA) and Emergency Use Authorization (EUA) Clinical Laboratory Improvement Amendment (CLIA)-waived COVID-19 point-of-care testing (POCT). Objectives: To (i) assess the status of NYS community pharmacists with POCT in the early stages of the COVID-19 pandemic, (ii) assess the readiness and willingness of community pharmacists to incorporate COVID-19 POCT into their workflow during a pandemic, and (iii) assess community pharmacists’ perception of the barrier to initiating COVID-19 POCT. Methods: This is a prospective cross-sectional study conducted from February 4 to February 21, 2021. An electronic survey consisting of 66 Likert-type questions, select all that apply, and fill-in-style questions were emailed to 250 Community Pharmacy Enhanced Service Network (CPESN) NY pharmacies, with a follow-up email sent halfway into the data collection period. The data were analyzed using descriptive statistics. Results: The result indicated that most participants (median = 5) demonstrated readiness and willingness to offer COVID-19 testing. Barriers to COVID-19 POCT were identified: impact on pharmacy workflow (59%), lack of payment mechanism (55%) and lack of sufficient training (21%). Most participants expressed interest in continuing POCT beyond the pandemic (86.1%). Conclusion: Community pharmacists in NYS reported willingness to initiate COVID-19 POCT. Addressing the identified barriers, such as workflow disruption and reimbursement challenges, will enable pharmacies to be better prepared to provide patient care, including POCT.

PMID:36242519 | DOI:10.1177/08971900221134642

Opt Express. 2022 Sep 12;30(19):34519-34532. doi: 10.1364/OE.465847.

ABSTRACT

The temporal characteristics of the free space optical communication (FSOC) turbulence fading channel are essential for analyzing the bit error rate (BER) performances and compiling the rationale of adaptive signal processing algorithms. However, the investigation is still limited since the majority of temporal sequence generation fails to combine the autocorrelation function (ACF) of the FSOC system parameters, and using the simplified formula results in the loss of detailed information for turbulence disturbances. In this paper, considering the ACF of engineering measurable atmospheric parameters, we propose a continuous-time FSOC channel fading sequence generation model that obeys the Gamma-Gamma (G-G) probability density function (PDF). First, under the influence of parameters such as transmission distance, optical wavelength, scintillation index, and atmospheric structural constant, the normalized channel fading models of ACF and PSD are established, and the numerical solution of the time-domain Gaussian correlation sequence is derived. Moreover, the light intensity generation model obeying the time-domain correlation with statistical distribution information is derived after employing the rank mapping, taking into account the association between the G-G PDF parameters and the large and small scales turbulence fading channels. Finally, the Monte Carlo numerical method is used to analyze the performances of the ACF, PDF, and PSD parameters, as well as the temporal characteristics of the generated sequence, and the matching relationships between these parameters and theory, under various turbulence intensities, propagation distances, and transverse wind speeds. Numerical results show that the proposed temporal sequence generation model highly restores the disturbance information in different frequency bands for the turbulence fading channels, and the agreement with the theoretical solution is 0.999. This study presents essential numerical simulation methods for analyzing and evaluating the temporal properties of modulated signals. When sophisticated algorithms are used to handle FSOC signals, our proposed temporal sequence model can provide communication signal experimental sample data generating techniques under various FSOC parameters, which is a crucial theoretical basis for evaluating algorithm performances.

PMID:36242462 | DOI:10.1364/OE.465847

Opt Express. 2022 Sep 12;30(19):34453-34467. doi: 10.1364/OE.469342.

ABSTRACT

We have proposed and demonstrated a denoising and extraction convolutional neural network (DECNN) composed of 1D denoising convolutional autoencoder (DCAE) and 1D residual attention network (RANet) modules to extract temperature and strain simultaneously in a Brillouin optical time-domain analysis (BOTDA) system. With DCAE for high-fidelity denoising and RANet for accurate and robust information extraction, integrated denoising and extraction of both temperature and strain have been realized for the first time under a single CNN framework. Both simulation and experiment have been conducted to statistically analyze the performance of the proposed scheme and compare it with the conventional equation solving method (CESM), which show that DECNN has large noise tolerance and robustness over a wide range of temperature/strain and signal-to-noise ratio (SNR) conditions. The mean standard deviation (SD) and root mean square error (RMSE) of the temperature/strain extracted by DECNN over a wide range of SNRs are only 0.2°C/9.7µɛ and 2°C/32.3µɛ at the end of 19.38 km long sensing fiber, respectively. At a relatively low SNR of 8.8 dB, DECNN shows 196 times better temperature/strain uncertainty and 146 times faster processing speed when compared with CESM.

PMID:36242457 | DOI:10.1364/OE.469342