Category: Nevin Manimala

MAGMA. 2022 Nov 30. doi: 10.1007/s10334-022-01049-9. Online ahead of print.

ABSTRACT

OBJECTIVE: An early metabolic signature associated with the responsiveness to treatment can be useful in the better management of septic shock patients. This would help clinicians in designing personalized treatment protocols for patients showing non-responsiveness to treatment.

METHODS: We analyzed the serum on Day 1 (n = 60), Day 3 (n = 47), and Day 5 (n = 26) of patients with septic shock under treatment using NMR-based metabolomics. Partial least square discriminant analysis (PLS-DA) was performed to generate the list of metabolites that can be identified as potential disease biomarkers having statistical significance (that is, metabolites that had a VIP score > 1, and p value < 0.05, False discovery rate (FDR) < 0.05).

RESULTS: Common significant metabolites amongst the three time points were obtained that distinguished the patients being responsive (R) and non-responsive (NR) to treatments, namely 3 hydroxybutyrate, lactate, and phenylalanine which were lower, whereas glutamate and choline higher in patients showing responsiveness.

DISCUSSION: The study gave these metabolic signatures identifying patients’ responsiveness to treatment. The results of the study will aid in the development of targeted therapy for ICU patients.

PMID:36449125 | DOI:10.1007/s10334-022-01049-9

J Math Biol. 2022 Nov 30;86(1):6. doi: 10.1007/s00285-022-01840-1.

ABSTRACT

It is well known that Keller-Segel models serve as a paradigm to describe the self aggregation phenomenon, which exists in a variety of biological processes such as wound healing, tumor growth, etc. In this paper, we study the existence of monotone decreasing spiky steady state and its linear stability property in the Keller-Segel model with logistic growth over one-dimensional bounded domain subject to homogeneous Neumann boundary conditions. Under the assumption that chemo-attractive coefficient is asymptotically large, we construct the single boundary spike and next show this non-constant steady state is locally linear stable via Lyapunov-Schmidt reduction method. As a consequence, the multi-symmetric spikes are obtained by reflection and periodic extension. In particular, we present the formal analysis to illustrate our rigorous theoretical results.

PMID:36449113 | DOI:10.1007/s00285-022-01840-1

Pediatr Nephrol. 2022 Nov 30. doi: 10.1007/s00467-022-05803-y. Online ahead of print.

ABSTRACT

BACKGROUND: Primary hyperoxaluria type 1 (PH1) is an autosomal recessive disease caused by the liver defect of oxalate metabolism, which leads to kidney failure and systemic manifestations. Until recently, liver transplantation was the only definitive treatment. The timing of liver transplantation can be early, while kidney function is still normal (pre-emptive liver transplantation-PLT), or when the patient reaches stage 5 chronic kidney disease (CKD) and needs combined liver-kidney transplantation. We aimed to determine the long-term kidney outcomes of PLT in PH1 patients.

METHODS: A retrospective single-center study of PH1 patients who were followed in our center between 1997 and 2017. We compared the kidney outcomes of patients who underwent PLT to those who presented with preserved kidney function and did not undergo PLT.

RESULTS: Out of 36 PH1 patients, 18 patients were eligible for PLT (eGFR > 40 mL/min/1.73 m² at the time of diagnosis). Seven patients underwent PLT (PLT group), while 11 continued conservative treatments (PLTn group). In the PLT group, the median eGFR at the time of PLT and at the end of the follow-up period (14-20 years) was 72 (range 50-89) and 104 (range 86-108) mL/min/1.73 m², respectively, and no patient died or reached stage 5 CKD. In the PLTn group, eight patients (72.7%) reached stage 5 CKD (median time to kidney replacement therapy was 11 years), and two patients died from disease complications (18.2%).

CONCLUSIONS: Pre-emptive liver transplantation preserved kidney function in patients with PH1 in our cohort. Early intervention can prevent kidney failure and systemic oxalosis in PH1. A higher resolution version of the Graphical abstract is available as Supplementary information.

PMID:36449101 | DOI:10.1007/s00467-022-05803-y

Surg Today. 2022 Nov 30. doi: 10.1007/s00595-022-02624-2. Online ahead of print.

ABSTRACT

PURPOSE: To assess the impact of surgical approach on morbidity, mortality, and the oncological outcomes of synchronous (SC) and metachronous (MC) colorectal cancer (CRC).

METHODS: All patients undergoing resection for double location CRC (SC or MC) between 2006 and 2020 were included. The exclusion criteria were polyposis or SC located on the same side.

RESULTS: Sixty-seven patients (age, 64.8 years; male, 78%) with SC (n = 41; 61%) or MC (n = 26; 39%) were included. SC was treated with segmental colectomy (right and left colectomy/proctectomy; n = 19) or extensive colectomy (subtotal/total colectomy or restorative proctocolectomy with pouch; n = 22). Segmental colectomy was associated with a higher incidence of anastomotic leakage (47.4 vs. 13.6%; p = 0.04) and a higher rate of medical morbidity (47.4 vs. 16.6%; p = 0.04). The mean number of lymph nodes harvested was similar. For MC, the second cancer was treated by iterative colectomy (n = 12) or extensive colectomy (n = 14) and there was no significant difference in postoperative outcomes between the two surgical approaches. The median follow-up period was 42.4 ± 29.1 months. The 5-year overall and disease-free survival of the SC and MC groups did not differ to a statistically significant extent.

CONCLUSIONS: Extensive colectomy should be preferred for SC to reduce morbidity and improve the prognosis. In contrast, iterative colectomy can be performed safely for patients with MC.

PMID:36449083 | DOI:10.1007/s00595-022-02624-2

Jpn J Nurs Sci. 2022 Nov 30:e12520. doi: 10.1111/jjns.12520. Online ahead of print.

ABSTRACT

AIM: To derive latent topics from free-text responses on the negative impact of the pandemic on research activities and determine similarities and differences in the resulting themes between academic-based and clinical-based researchers.

METHODS: We performed a secondary analysis of free-text responses from a cross-sectional online survey conducted by the Japan Academy of Nursing Science of its members in early 2020. The participants were categorized into two groups by workplace (academic-based and clinical-based researchers). Latent Dirichlet allocation (LDA) topic modeling was used to extract latent topics statistically and list important keywords/text associated with the topics. After organizing similar topics by principal component analysis (PCA), we finally derived topic-associated themes by reading the keywords/texts and determining the similarity and differences of the themes between the two groups.

RESULTS: A total of 201 respondents (163 academic-based and 38 clinical-based researchers) provided free-text responses. LDA identified eight and three latent topics for the academic-based and clinical-based researchers, respectively. While PCA re-grouped the eight topics derived from the former group into four themes, no merging of the topics from the latter group was performed resulting in three themes. The only theme common to the two groups was “barriers to conducting research,” with the remaining themes differing between the groups.

CONCLUSIONS: Using LDA topic modeling with PCA, we identified similarities and differences in the themes described in free-text responses about the negative impact of the pandemic between academic-based and clinical-based researchers. Measures to mitigate the negative impact of pandemics on nursing research may need to be tailored separately.

PMID:36448530 | DOI:10.1111/jjns.12520

J Appl Clin Med Phys. 2022 Nov 30:e13852. doi: 10.1002/acm2.13852. Online ahead of print.

ABSTRACT

The present study was conducted as part of a comprehensive work to establish National Diagnostic Reference Levels (NDRLs) in Sri Lanka for the first time. DRLs can be used as an effective optimization tool for identifying unusually high or low patient doses during X-ray examinations. This study aims to propose institutional DRLs (IDRLs) by measuring the kerma-area product (KAP) of adult patients undergoing routine projection X-ray examinations. The median and the 75th percentile KAP values obtained were compared with that of the single institution KAP values reported from India and Greece. This descriptive cross-sectional study was conducted in a public hospital in Uva province, Sri Lanka, with 400 adult patients aged 18-87 years and weighing 58 ± 20 kg. The patient-specific information (age, sex, weight, and height) and corresponding exposure parameters (tube voltage and current-exposure time product) were obtained. The KAP values were measured, and descriptive statistics were utilized for data analysis. The median KAP values obtained were proposed as IDRLs. The IDRLs in Gy.cm² were 0.23 for cervical spine anterior-posterior (AP), 0.19 for cervical spine lateral (LAT), 0.10 for chest posterior-anterior (PA), 0.06 for knee joint AP, 0.05 for knee joint LAT, 1.47 for KUB AP, 0.85 for lumbar spine AP, 1.97 for lumbar spine LAT, 0.29 for shoulder joint AP, 0.61 for skull PA, and 0.60 for skull LAT examinations. The maximum to minimum ratio of KAP values ranged from 2.4 for KUB AP to 6.3 for the cervical spine AP examinations. The median and the 75th percentile of most of the examinations were comparable to corresponding KAP values reported by the countries mentioned above, except for the skull PA and LAT examinations. Accordingly, interquartile ranges of exposure parameters are recommended for skull examinations to improve the optimization of patient doses.

PMID:36448529 | DOI:10.1002/acm2.13852

Int J Urol. 2022 Nov 30. doi: 10.1111/iju.15106. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the involvement of pretreatment C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR) in the prognosis of patients who underwent intravesical bacillus Calmette-Guérin (BCG) therapy for non-muscle invasive bladder cancer (NMIBC).

METHODS: The clinicopathological data of 1709 patients with NMIBC who underwent initial intravesical BCG therapy after transurethral resection of bladder tumor were retrospectively analyzed to evaluate the outcome of intravesical BCG therapy in a multicenter study conducted by the Japan Urological Oncology Group. The prognoses of these patients were analyzed to determine whether the biomarkers (CRP and NLR) could predict the efficacy of intravesical BCG therapy. Patients were divided into two groups according to the pretreatment CRP and NLR, with cutoff values defined as CRP ≥ 0.5 mg/dl and NLR ≥ 2.5, based on several previous reports.

RESULTS: In the univariable analysis, CRP ≥ 0.5 mg/dl was significantly associated with intravesical recurrence, cancer-specific survival, and bladder cancer (BC) progression, while NLR ≥ 2.5 was not significantly associated with patient prognosis. In the multivariable analysis, CRP ≥ 0.5 mg/dl was significantly associated with intravesical recurrence and BC progression. The concordance index was used to examine the accuracy in predicting recurrence and progression events. While CRP was slightly, though not statistically significant, inferior to the European Association of Urology risk classification, the combination of them showed improved predictive accuracy.

CONCLUSION: This study suggests that CRP can be a prognostic factor after intravesical BCG therapy and may provide useful data for determining treatment and follow-up strategies for patients with NMIBC.

PMID:36448522 | DOI:10.1111/iju.15106

Acta Ophthalmol. 2022 Nov 30. doi: 10.1111/aos.15290. Online ahead of print.

ABSTRACT

PURPOSE: The present study aimed to evaluate the efficacy and safety of ultrasound ciliary plasty (UCP) in patients with open-angle glaucoma for three consecutive years.

METHODS: Sixty-one patients (62 eyes) with primary and secondary glaucoma were enrolled to undergo UCP. The primary outcome measures were intraocular pressure (IOP) reduction, success rates, glaucoma medication use and visual acuity after UCP. An IOP reduction of 20% compared to the baseline value without re-intervention was considered a successful treatment. Complete success was defined as cessation of antiglaucoma medications. Secondary outcome measures included intraoperative and postoperative complications. Measurements were performed preoperatively and at the first week, and 1, 3, 6, 12, 18, 24, 30 and 36 months postoperatively.

RESULTS: A total of 41 patients (41 eyes) were evaluated 36-month after UCP. The mean ± SD values of IOP preoperatively at 1 day, 1 week, 1; 3; 6; 12; 18; 24; 30 and 36 months postoperatively were 22.7 ± 5.0 mmHg, 17.1 ± 4.2 mmHg (p < 0.001), 15.7 ± 4.8 mmHg (p < 0.001), 18.8 ± 4.8 mmHg (p < 0.001), 17.3 ± 3.7 mmHg (p < 0.001), 16.9 ± 3.2 mmHg (p < 0.001), 16.6 ± 2.7 mmHg (p < 0.001), 16.3 ± 3.0 mmHg (p < 0.001), 15.8 ± 3.4 mmHg (p < 0.001), 15.3 ± 2.1 mmHg (p < 0.001) and 16.3 ± 3.0 mmHg (p < 0.001), respectively. The mean IOP at the last follow-up was reduced by 28.5%. The qualified success rate was 64.0%. All patients at 36-month follow-up visit required the use of antiglaucoma medications – none of the patients achieved complete success. The decrease in the number of antiglaucoma medications was statistically significant at each follow-up visit compared to the baseline. Choroid detachment was observed in three patients (4.8%), while macular oedema was observed in three patients (4.8%) after the procedure. No other major intraoperative or postoperative complications occurred.

CONCLUSION: Ultrasound ciliary plasty seems to be an effective and well-tolerated method to reduce IOP in patients with refractory glaucoma. Further studies with a larger group are needed to confirm the efficacy of this procedure.

PMID:36448501 | DOI:10.1111/aos.15290

Int J Inj Contr Saf Promot. 2022 Nov 30:1-7. doi: 10.1080/17457300.2022.2147193. Online ahead of print.

ABSTRACT

The study examined the extent, demographics and risks for child pedestrian, burns and drowning mortality in Johannesburg. Information on the demographics, scene and temporal circumstances for childhood injury deaths from 2000 to 2010 was gleaned from the National Injury Mortality Surveillance System. Descriptive statistical methods were used. The study recorded 756 pedestrian (8.7/100,000), 439 drowning (5.1/100,000), and 399 burn injury deaths (4.6/100,000) among children aged 0-14 years. Male children were the main victims, with male-to-female ratios of 2.3 for drowning, 1.7 for pedestrian and 1.2 for burn mortality. The pattern of child mortality differed across age groups with older children recording higher rates for pedestrian deaths and younger children higher rates for the non-traffic deaths. Pedestrian and burn mortality especially affected black children, while drowning affected both black and white children. The time, day and month of greatest injury mortality varied by injury cause, with e.g. pedestrian mortality common in afternoons and evenings, weekends, and dispersed across the year although increasing towards year end. The study highlighted the salience of differentiating risks for childhood injuries by discrete external cause for purposes of informing prevention responses.

PMID:36448497 | DOI:10.1080/17457300.2022.2147193

Nurs Open. 2022 Nov 30. doi: 10.1002/nop2.1509. Online ahead of print.

ABSTRACT

AIMS: To understand the status quo of self-directed learning ability, self-efficacy and academic burnout of junior nursing college students, since the closed management mode was implemented during COVID-19 pandemic disease.

DESIGN: Cross-sectional study.

METHODS: Participants came from 3,051 junior nursing college students of a college in Zhengzhou City, Henan Province, China. Data were collected by online questionnaire and analysed by SPSS25.0 (a statistical package for social science) and AMOS24.0 software.

RESULTS: High self-directed learning ability and self-efficacy were related to low levels of academic burnout (p < .01). In addition, the analysis of mediation effect indicated that the influence of self-directed learning ability on academic burnout was not mediated by self-efficacy.

PMID:36448492 | DOI:10.1002/nop2.1509