Category: Nevin Manimala

Clin Res Cardiol. 2022 Oct 14. doi: 10.1007/s00392-022-02114-y. Online ahead of print.

ABSTRACT

BACKGROUND: Improved imaging modalities contributed to increasing awareness of cardiac amyloidosis. Contemporary data on frequency trends in Germany are lacking.

METHODS: In a retrospective study using health claims data of a German statutory health insurance, patients with diagnostic codes of amyloidosis and concomitant heart failure between 2009 and 2018 were identified.

RESULTS: Prevalence increased from 15.5 to 47.6 per 100,000 person-years, and incidence increased from 4.8 to 11.6 per 100,000 person-years, with a continuous steepening in the slope of incidence trend. In patients with amyloidosis and heart failure age and proportion of men significantly increased, whereas the frequency of myeloma and nephrotic syndrome significantly decreased over time. Median (IQR) survival time after first diagnosis was 2.5 years (0.5-6 years), with a 9% (95% CI 2-15%, p = 0.008) reduced risk of death in the second compared to the first 5 years of observation. In the 2 years prior and 1 year after diagnosis, mean total health care costs were 6568 €, 11,872 € and 21,955 € per person and year.

CONCLUSION: The rise in cardiac amyloidosis has continuously accelerated in the last decade. Considering the adverse outcome and high health care burden, further effort should be put on early detection of the disease to implement available treatment.

PMID:36241897 | DOI:10.1007/s00392-022-02114-y

JCO Oncol Pract. 2022 Oct 14:OP2200280. doi: 10.1200/OP.22.00280. Online ahead of print.

ABSTRACT

PURPOSE: Comprehensive health care centers are increasingly popular as they offer inclusive health care services under one roof. Often, these centers are formed by merging previously separate clinics. However, there is a lack of systematic guidance on the interprofessional, and interteam and intrateam dynamics that may develop during such an organizational change process. Using team process literature, we identify a possible model to explain how merging into a comprehensive cancer center (CCC) might influence health care teams and their subsequent outcomes, including patient experience.

METHODS: We used a mixed-method research design. Qualitative data were collected via semistructured interviews from 20 health care professionals employed at a recently merged CCC. During the time frame the interviews were collected, quantitative data were collected from 50 patients receiving treatment at the cancer center through anonymous paper-pencil surveys. Qualitative interviews were analyzed using thematic analysis, on the basis of the input-process-output team dynamics framework. Descriptive statistics were calculated for patient experience data. Trends between data collections were identified.

RESULTS: On the basis of our qualitative analysis, we provide an input-process-output framework that documents positive and negative aspects of interteam and intrateam dynamics associated with the merger process. Additionally, a number of connections were found between health care professional perceptions and quality patient experiences (eg, merger impacts on interteam and patient communication).

CONCLUSION: Our findings and model may assist in future merging efforts. Future CCCs may use the proposed framework to better understand and visualize their postmerger progress, in particular from the aspects of interprofessional, and interteam and intrateam dynamics.

PMID:36240476 | DOI:10.1200/OP.22.00280

Br J Radiol. 2022 Oct 14:20220367. doi: 10.1259/bjr.20220367. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate the efficacy of pretreatment ADC and Ki-67 index in the prediction of the response to neoadjuvant chemotherapy (NACT) in advanced olfactory neuroblastoma (ONB) patients.

METHODS: A total of 21 advanced ONB patients (mean 43.48 years ± 14.26; range 25-69 years; 13 men and 8 women) with diffusion weighted imaging (DWI) before NACT between June 2015 and October 2021 were retrospectively analyzed. Patients were categorized into responders and non-responders according to RECIST 1.1 after two cycles of NACT. The clinical data, ADC_mean value and Ki-67 index were analyzed.

RESULTS: Kadish stage, ADC_mean value and Ki-67 index showed statistical significance between responders and non-responders. Patients with Kadish C stage were more likely to respond to platinum-based NACT (p = 0.035). Patients with the lower ADC_mean value showed response to NACT (p = 0.002) and the cutoff point was 1.04 × 10^-3 mm²/s. Patients with the higher Ki-67 index showed response to NACT (p = 0.003) and the cutoff point was 17.5%. Predictive performance of Ki-67 index and ADC_mean value showed no significance between responders and non-responders (p = 0.865). A significant negative correlation was found between ADC_mean value and Ki-67 index (r = -0.539, p = 0.038).

CONCLUSIONS: The pretreatment ADC_mean value, Ki-67 index and Kadish stage have the potential to predict the response to NACT in advanced ONB patients.

ADVANCES IN KNOWLEDGE: This is the first study that investigated the feasibility of DWI in predicting the response to NACT in ONB patients, and showed that Kadish stage, pretreatment ADC_mean and Ki-67 index may play an important role in the prediction.

PMID:36240450 | DOI:10.1259/bjr.20220367

Infect Dis (Lond). 2022 Oct 14:1-8. doi: 10.1080/23744235.2022.2131901. Online ahead of print.

ABSTRACT

BACKGROUND: The epidemiology of enterococcal bacteraemia has changed worldwide and vancomycin-resistant enterococci increasingly cause healthcare-associated infections) with limited treatment options. Studies show heterogeneity among countries, regions and individual hospitals.

METHODS: We retrospectively analysed enterococcal bacteraemia with Enterococcus faecalis and E. faecium at the largest hospital in Croatia, University Hospital Centre Zagreb from January 2017 to December 2021.

RESULTS: A total of 432 cases of enterococcal bacteraemia were identified with 256 (59.3%) due to E. faecalis and 176 (40.7%) to E. faecium. Enterococcal bacteraemia occurred more frequently in men (n = 270; 62.5%) and the median age of all patients was 62 years (IQR: 0-92). We found statistically significant increase in the incidence trend of bacteraemic episodes with an annual percent change of 20.9% (95% confidence interval 14.3 to 27.8; p = .002) predominantly due to an increase of E. faecalis bacteraemia. The majority of patients (362/432; 83.8%) had healthcare-associated infections and 38.0% (165/432) of patients were in the intensive care unit. The proportion of vancomycin-resistant enterococcal bacteraemia increased from 12.7% (n = 8/63) in 2017 to 25.7% (n = 29/113) in 2021, statistically significant increasing trend (p = .0455), mainly due to an increased proportion of vancomycin-resistant E. faecium (p = .0169).

CONCLUSIONS: This is the first study describing the trends in enterococcal bacteraemia and vancomycin-resistance in enterococci in Croatia. We found a rising trend in enterococcal bacteraemia and in the proportion of vancomycin resistance and identified the most vulnerable patient groups, notably intensive care unit patients.

PMID:36240424 | DOI:10.1080/23744235.2022.2131901

Phys Rev Lett. 2022 Sep 30;129(14):146801. doi: 10.1103/PhysRevLett.129.146801.

ABSTRACT

Chiral gapless boundary modes are characteristic of quantum Hall (QH) states. For hole-conjugate fractional QH phases counterpropagating edge modes (upstream and downstream) are expected. In the presence of electrostatic interactions and disorder these modes may renormalize into charge and upstream neutral modes. Orthodox models of Laughlin phases anticipate only a downstream charge mode. Here we show that in the latter case, in the presence of a smooth confining potential, edge reconstruction leads to the emergence of pairs of counterpropagating modes, which, by way of mode renormalization, may give rise to nontopological upstream neutral modes, possessing nontrivial statistics. This may explain the experimental observation of ubiquitous neutral modes, and the overwhelming suppression of anyonic interference in Mach-Zehnder interferometry platforms. We also point out other signatures of such edge reconstruction.

PMID:36240414 | DOI:10.1103/PhysRevLett.129.146801

Water Sci Technol. 2022 Oct;86(7):1790-1809. doi: 10.2166/wst.2022.300.

ABSTRACT

The present research aimed to analyse the impact of economical Fe impregnated polyethylene terephthalate (PET) char (PETC-Fe) for adsorption of As (III) through series of column experiments. For an inlet arsenite concentration of 1,000 μg/L, PETC-Fe exhibits excellent uptake capacity of 1,892 μg/g. Central composite design (CCD) in response surface methodology (RSM) was used to evaluate the influence of various process variables on the response function (breakthrough time) for optimization and assessment of interaction effects. The breakthrough time is more responsive to influent As (III) concentration and bed height than inlet flow rate, according to the perturbation plot. Adams-Bohart, Bed Depth Service Time (BDST) model, and Thomas models were used to model the dynamics of the adsorption system. The BDST model suited the experimental data well in the early part of the breakthrough curve, but there were minor variations over the breakpoints. Despite the fact that the experimental values and the data sets estimated using the Adams-Bohart model followed a similar pattern, they differed slightly. The PETC-Fe was found to be a sustainable and highly economical adsorbent, with a desorption performance of more than 97%, indicating the adsorbent’s reusability. This adsorbent’s excellent As (III) uptake capacity and regeneration performance imply that it might be used in industrial/domestic applications, and the information obtained could aid in future scaling up of the adsorption system.

PMID:36240312 | DOI:10.2166/wst.2022.300

PLoS One. 2022 Oct 14;17(10):e0276235. doi: 10.1371/journal.pone.0276235. eCollection 2022.

ABSTRACT

Urbanization is a comprehensive process of mutual influence among the population, economy, society and living environment, and it depends on the synergy of a series of factors. This paper uses the statistical data of 76 counties in Xinjiang from 1996 to 2018 to construct a comprehensive urbanization evaluation system. Based on the entropy method, comprehensive evaluation model and coupling coordination model, from the scales of time and space, this paper discusses the current situation of the coordinated development of population, economy, society and living environment factors in counties in Xinjiang in the process of urbanization. Local spatial autocorrelation analysis is used to further study the spatial agglomeration effect of the coupling and coordination of urbanization development in the counties. The results show the following: (1) The comprehensive urbanization level of 76 counties in Xinjiang has the characteristics of “center-periphery” development, and high-level counties are clustered on the northern slopes of the Tian Mountains. (2) Most counties are in a serious state of imbalance; notably, the degree of population-economy-society-living environment coupling and coordination in the border counties and towns is in an unsatisfactory state. (3) The county-level cities in Northern Xinjiang belong to the diffusion and spillover areas, the county-level cities in southern Xinjiang belong to the polarization benefit areas, and most other counties are in the state of no spillover effect.

PMID:36240244 | DOI:10.1371/journal.pone.0276235

PLoS One. 2022 Oct 14;17(10):e0275874. doi: 10.1371/journal.pone.0275874. eCollection 2022.

ABSTRACT

BACKGROUND: Benzo(a)pyrene (BaP), an important polycyclic aromatic hydrocarbons (PAH) component of cigarette/tobacco smoking, is known to cause adverse health effects and is responsible for various life-threatening conditions including cancer. However, it is not yet clear whether BaP contributes to the macrophage- and astrocyte-mediated inflammatory response.

METHODS: We examined the acute (up to 72 h) effects of BaP on the expression of antioxidant enzymes (AOEs), cytokines/chemokines, and cytochromes P450 (CYP) enzymes in astrocytic cell lines, SVGA, and chronically HIV-infected U1 macrophage. The treated cells were examined for mRNA, protein levels of CYPs, AOEs superoxide dismutase-1 (SOD1) and catalase (CAT), cytokines/chemokines, using Western blot, multiplex ELISA, and reactive oxygen species (ROS) by flow cytometry analysis.

RESULTS: Upon acute exposure, BaP (1 μM) showed a significant increase in the mRNA levels of CYPs (CYP1A1 and CYP1B1), and pro-inflammatory cytokine IL-1β in SVGA cells following BaP for 24, 48, and 72h. In addition, we observed a significant increase in the mRNA levels of SOD1 and CAT at 24h of BaP treatment. In contrast, BaP did not exert any change in the protein expression of AOEs and CYP enzymes. In U1 cells, however, we noticed an interesting increase in the levels of MCP-1 as well as a modest increase in TNFα, IL-8 and IL-1β levels observed at 72 h of BaP treatment but could not reach to statistically significant level.

CONCLUSIONS: Overall, these results suggest that BaP contributes in part to macrophage and astrocyte-mediated neuroinflammation by mainly inducing IL-1β and MCP-1 production, which is likely to occur with the involvement of CYP and/or oxidative stress pathways.

PMID:36240258 | DOI:10.1371/journal.pone.0275874

Acta Med Port. 2022 Oct 14. doi: 10.20344/amp.18735. Online ahead of print.

ABSTRACT

INTRODUCTION: Parathyroid adenoma is the most frequent cause of primary hyperparathyroidism. In recent years, the preoperative location of parathyroid adenomas allowed minimally invasive surgical techniques that have become preferred over the traditional bilateral neck exploration. The more recent guidelines on this subject highlight the role of nuclear medicine imaging tests. The aim of this study was to review the current role of Doppler ultrasound (US) in assessing the preoperative location of parathyroid adenomas in patients with primary hyperparathyroidism.

MATERIAL AND METHODS: Retrospective study based on data from patients with primary hyperparathyroidism that underwent parathyroidectomy between January 2013 and January 2022 at the Centro Hospitalar Universitário Lisboa Central. Statistical analysis was performed with IBM SPSS Statistics, version 26.0.0.0®.

RESULTS: Parathyroidectomy was performed in 171 patients (77.8% females) with primary hyperparathyroidism. Cervical Doppler ultrasound was the most performed test (64.3%, n = 110) for preoperative location and detected a suspicious lesion in 98 patients (89.1%). The preoperative location of the parathyroid adenomas was assessed through the Doppler ultrasound and was compared with the surgical reports and histological findings; a correct identification was made in 76 patients (77.6%). Doppler ultrasound slightly underestimated the mean adenoma size (18.1 ± 7.7 mm preoperative versus 22 ± 8.4 mm postoperative). Calcium, parathyroid hormone levels, adenoma size and concomitant presence of thyroid nodules did not affect the accuracy of Doppler ultrasound.

CONCLUSION: Doppler ultrasound showed high diagnostic accuracy even in patients with nodular thyroid disease regardless of calcium and parathyroid hormone levels and adenoma size. Furthermore, its safety, affordability and availability should favor its use as first line test in primary hyperparathyroidism to assess the preoperative location of parathyroid adenomas.

PMID:36240233 | DOI:10.20344/amp.18735

PLoS Negl Trop Dis. 2022 Oct 14;16(10):e0010795. doi: 10.1371/journal.pntd.0010795. Online ahead of print.

ABSTRACT

Mycetoma is widespread in tropical and subtropical regions favouring arid areas with low humidity and a short rainy season. Sudan is one of the highly endemic countries for mycetoma. Estimating the population at risk and the number of cases is critical for delivering targeted and equitable prevention and treatment services. In this study, we have combined a large dataset of mycetoma cases recorded by the Mycetoma Research Centre (MRC) in Sudan over 28 years (1991-2018) with a collection of environmental and water and hygiene-related datasets in a geostatistical framework to produce estimates of the disease burden across the country. We developed geostatistical models to predict the number of cases of actinomycetoma and eumycetoma in areas considered environmentally suitable for the two mycetoma forms. Then used the raster dataset (gridded map) with the population estimates for 2020 to compute the potentially affected population since 1991. The geostatistical models confirmed this heterogeneous and distinct distribution of the estimated cases of eumycetoma and actinomycetoma across Sudan. For eumycetoma, these higher-risk areas were smaller and scattered across Al Jazirah, Khartoum, White Nile and Sennar states, while for actinomycetoma a higher risk for infection is shown across the rural districts of North and West Kurdufan. Nationally, we estimated 63,825 people (95%CI: 13,693 to 197,369) to have been suffering from mycetoma since 1991 in Sudan,51,541 people (95%CI: 9,893-166,073) with eumycetoma and 12,284 people (95%CI: 3,800-31,296) with actinomycetoma. In conclusion, the risk of mycetoma in Sudan is particularly high in certain restricted areas, but cases are ubiquitous across all states. Both prevention and treatment services are required to address the burden. Such work provides a guide for future control and prevention programs for mycetoma, highly endemic areas are clearly targeted, and resources are directed to areas with high demand.

PMID:36240229 | DOI:10.1371/journal.pntd.0010795