Category: Nevin Manimala

Cancer Med. 2021 Nov 12. doi: 10.1002/cam4.4368. Online ahead of print.

ABSTRACT

BACKGROUND: There is currently no recognized first-line treatment strategy for ovarian neuroendocrine tumors (NETs). Furthermore, because of the low incidence of ovarian NETs, no studies have reported prognostic statistics derived from large samples. This retrospective study aimed to investigate the clinical behavior of ovarian NETs.

METHODS: The Surveillance, Epidemiology, and End Results database was used to identify women diagnosed with ovarian NETs from 2004 to 2015. Overall survival (OS), cancer-specific survival (CSS), and independent prognostic factors for ovarian NETs were evaluated. The effects of different treatments on prognosis were also compared, as were OS and CSS rates for histological subtypes.

RESULTS: The 5-year OS rates were 83.3%, 30.0%, 20.3%, and 9.8% for patients in stages I (n = 159), II (n = 23), III (n = 101), and IV (n = 148), respectively. The 5-year CSS rates were 85.6%, 41.7%, 21.2%, and 9.8% for patients in stages I-IV, respectively. Age, American Joint Committee on Cancer (AJCC) stage, lymph node metastasis, treatment, and histological type were related to poor OS and CSS. In the early stage, the 5-year OS and CSS rates were 97.03% and 96.90%, respectively. For patients in the advanced stage receiving comprehensive treatment (surgery + chemotherapy + radiotherapy), the 5-year OS and CSS rates were 72.9% and 70.00%, respectively. When comparing low- and high-grade neuroendocrine carcinoma, 5-year OS rates were 93.96% and 7.01%, 5-year CSS rates were 97.44% and 7.31%, 10-year OS rates were 93.56% and 2.34%, and 10-year CSS rates were 97.44% and 4.88%, respectively.

CONCLUSION: Age, AJCC stage, treatment, and histological type are independent prognostic factors of ovarian NETs. OS and CSS are relatively good for early-stage cases treated with surgery alone, whereas more comprehensive treatment is required to improve OS and CSS in the advanced stage.

PMID:34773393 | DOI:10.1002/cam4.4368

BJOG. 2021 Nov 12. doi: 10.1111/1471-0528.17005. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the impact of uterine contractile activity on the outcome of trial of labour after caesarean section (TOLAC).

DESIGN: Secondary, blinded analyses of a prospective TOLAC cohort.

SETTING: Two labour wards, in a university tertiary hospital and a central hospital.

POPULATION: 194 TOLAC parturients with intrauterine tocodynamometry during labour.

METHODS: Analysis of intrauterine pressure, frequency of contractions and baseline tonus of uterine muscle in 30-minute periods for four hours prior to birth.

MAIN OUTCOME MEASURES: Primary Outcome: uterine contractile activity during TOLAC. Secondary aims: contributors associated with failed TOLAC and uterine rupture.

RESULTS: TOLAC succeeded in 74% of cases. Uterine contractile activity, expressed as intrauterine pressure, was significantly higher in successful compared with failed TOLAC (210 vs 170 MVU). The statistically significant risk factors of failed TOLAC, after multivariate regression analysis, were prolonged gestational age, reduced cervical dilatation at admission, and lower mean intrauterine pressure. In cases of uterine rupture contractile activity did not differ from that in failed TOLAC. Cervical ripening with a Foley catheter appeared to be a risk factor of uterine rupture, as well as cervical dilatation < 3 cm at admission. The incidence of total uterine rupture was 2.6% (n=5).

CONCLUSIONS: Parturients with successful vaginal birth had higher uterine contractile activity than those experiencing failed TOLAC or uterine rupture despite similar use of oxytocin. Induction of labour with a Foley catheter turned out to be a risk factor of uterine rupture during TOLAC among parturients with no previous vaginal delivery.

PMID:34773355 | DOI:10.1111/1471-0528.17005

Oral Dis. 2021 Nov 13. doi: 10.1111/odi.14080. Online ahead of print.

ABSTRACT

OBJECTIVE: The present study aimed to characterize and differentiate the ultrasonography (US) and computed tomography (CT) features of mammary analogue secretory carcinoma (MASC) and acinic cell carcinoma (AciCC).

METHODS AND PATIENTS: A total of 83 patients with clinically proven MASC and AciCC were analyzed. The following characteristics were assessed on US, CT, and magnetic resonance imaging: lesion size, shape, margin, echogenicity, echotexture, cystic components, posterior echo, vascularity, density, degree of enhancement, enhancement pattern, signal intensity (SI) on T1 and T2 weighted images (WI), hemorrhages, and lymph node enlargement.

RESULTS: Similarities were observed between the imaging performance of MASC and AciCC. Differences between the two characteristics of shape on US and cystic components on CT were statistically significant. The proportion of MASC to regular shape on US (P = 0.006) and cystic components on CT (P = 0.027) was significantly higher than that of AciCC. Regular shape on US had the highest sensitivity in the identification of MASC and AciCC, while regular shape on US + cystic component on CT had the highest specificity.

CONCLUSIONS: The shape on US and cystic components on CT are key characteristics for distinguishing MASC and AciCC.

PMID:34773340 | DOI:10.1111/odi.14080

Int J Ment Health Nurs. 2021 Nov 12. doi: 10.1111/inm.12950. Online ahead of print.

ABSTRACT

Safewards is an internationally adopted framework that provides interventions to reduce conflict and containment in healthcare settings. This systematic review evaluated the effect of Safewards on conflict and containment events in inpatient units and the perceptions of staff and consumers. Quantitative, qualitative, and mixed-methods studies were considered for inclusion. Following the Joanna Briggs Institute methodology, two reviewers independently screened, appraised, and extracted data. Qualitative data were synthesized using inductive-thematic analysis. Quantitative and qualitative data were integrated with a convergent-segregated approach and presented in tabular and narrative format. A search of 13 databases and grey literature yielded 14 studies of variable methodological quality. Four studies reported reduced rates of conflict and one study reported reductions that were not statistically significant. Six studies reported reductions in rates of containment, three studies found no statistical significance and one study reported statistically significant reductions at follow-up. Staff and consumers in four studies reported an improved experience of safety. Three themes were developed as follows: (i) therapeutic hold, cohesion, support and the environment, (ii) conflict, containment and the experience of safety, and (iii) the complexities of adapting and embedding change. This review found most staff and consumers reported Safewards improved therapeutic relationships, cohesion, and ward atmosphere. Staff and consumers reported improved ward atmosphere, leading to consumer-centred, recovery-oriented care. Safewards improved the experience of safety from the perspective of staff and consumers when combined with ongoing training, leadership and time for consolidation. While results are promising they should be used cautiously until more robust evidence is established.

PMID:34773348 | DOI:10.1111/inm.12950

Mol Ecol. 2021 Nov 12. doi: 10.1111/mec.16271. Online ahead of print.

ABSTRACT

Ecological adaptive differentiation alters both the species diversity and intraspecific genetic diversity in forests, thus affecting the stability of forest ecosystems. Therefore, knowledge of the genetic underpinnings of the ecological adaptive differentiation of forest species is critical for effective species conservation. In this study, single-nucleotide polymorphisms (SNPs) from population transcriptomes were used to investigate the spatial distribution of genetic variation in Liriodendron to assess whether environmental variables can explain genetic divergence. We examined the contributions of environmental variables to population divergence and explored the genetic underpinnings of local adaptation using a landscape genomic approach. Niche models and statistical analyses showed significant niche divergence between L. chinense and L. tulipifera, suggesting that ecological adaptation may play a crucial role in driving interspecific divergence. We detected a new fine-scale genetic structure in L. chinense, and divergence of the six groups occurred during the late Pliocene to early Pleistocene. Redundancy analysis (RDA) revealed significant associations between genetic variation and multiple environmental variables. Environmental association analyses identified 67 environmental association loci (EALs; nonsynonymous SNPs) that underwent interspecific or intraspecific differentiation, 28 of which were associated with adaptive genes. These 28 candidate adaptive loci provide substantial evidence for local adaptation in Liriodendron. Our findings reveal ecological adaptive divergence pattern between Liriodendron species and provide novel insight into the role of heterogeneous environments in shaping genetic structure and driving local adaptation among populations, informing future L. chinense conservation efforts.

PMID:34773328 | DOI:10.1111/mec.16271

J Sleep Res. 2021 Nov 13:e13516. doi: 10.1111/jsr.13516. Online ahead of print.

ABSTRACT

Unemployed people could be at risk of developing inefficient sleep habits by spending excessive time in bed, as they lack a structuring activity. This could impact their mental health and reintegration into labour. This study aims to analyse possible associations between employment status and sleep parameters using actigraphy. Subjects (148 employed and 50 unemployed) were drawn from a German population-based cohort. Sleep parameters were measured with the SenseWear Bodymedia Pro 3 armband. Comparison of means concerning sleep duration, sleep efficiency, time of sleep and sleep fragmentation was performed separately for week days and weekends. Multiple linear regression analysis was performed to analyse group differences controlling for covariates. Finally, we defined cut-off scores for each sleep variable, and analysed the distribution of subjects above and below these values. Unemployed people did not sleep significantly longer than employed people. However, on week days, they displayed night sleep efficiency reduced by on average > 5% points, they lay down for 28 min longer, had later mid sleep time (38 min) and sleep offset (55 min), as well as more frequent awakenings after sleep onset accounting for being awake 28 min longer (all p ≤ 0.005). Sleep in unemployed subjects compared with employed subjects aged 41-64 years was less efficient, more fragmented and shifted to a later point of the night. Results support prior findings that unemployment has a negative influence on sleep quality. Unemployed individuals could benefit from intervention programmes aiming at the adoption of healthier sleep habits.

PMID:34773314 | DOI:10.1111/jsr.13516

Alcohol Clin Exp Res. 2021 Nov 13. doi: 10.1111/acer.14743. Online ahead of print.

ABSTRACT

BACKGROUND: Alcohol, insulin resistance (IR), and hepatitis C (HCV) are all significant contributors to adverse outcomes of chronic liver disease. Latinos are disproportionately affected by these risk factors. We investigated the relationship between alcohol use and insulin action in a large prospective Latino cohort with and without HCV.

METHODS: One hundred fifty-three non-diabetic Latinos (60 HCV+, 93 HCV-) underwent clinical evaluation and metabolic testing; 56 had repeat testing over a median follow-up of 1.5 years. Peripheral IR and hepatic IR were measured via steady-state plasma glucose (SSPG) and endogenous glucose production during a 2-step 240-minute insulin suppression test. Insulin secretion (IS) was measured using the graded glucose infusion test. Alcohol use was categorized as none, moderate (≤1 drink/day for women and ≤2 drinks/day for men), and heavy (not moderate). Multivariable models including HCV status assessed associations of alcohol use with baseline SSPG, hepatic IR and IS, and with changes in these parameters over time.

RESULTS: Overall, the median age was 44 years, 63.4% were male, 66.7% overweight/obese, and 31.9% had heavy lifetime alcohol use (60.4% moderate lifetime alcohol use). SSPG and IS were similar by levels of alcohol use at baseline and alcohol use was not statistically significantly associated with change in these measures over time. However, lifetime daily heavy alcohol use (vs not heavy, coef 2.4 μU-mg/kg-min-ml, p=0.04) and HCV status (coef 4.4 μU-mg/kg-min-ml, p=0.0003) were independently associated with higher baseline hepatic IR, and current heavy alcohol use was associated with greater change in hepatic IR in follow-up (coef 5.8 μU-mg/kg-min-ml, p=0.03).

CONCLUSIONS: In this Latino cohort, lifetime and current heavy alcohol use influenced hepatic IR and its change over time. Strategies to improve rates of alcohol cessation along with lifestyle modification and anti-HCV therapy to reduce metabolic risk are critical to prevent adverse liver and metabolic outcomes in Latinos.

PMID:34773280 | DOI:10.1111/acer.14743

Photodermatol Photoimmunol Photomed. 2021 Nov 12. doi: 10.1111/phpp.12753. Online ahead of print.

ABSTRACT

BACKGROUND: Photodynamic therapy (PDT) has become one of the most effective therapies for the treatment of actinic keratosis, allowing the removal of more than one lesion in a single session. However, the pain sustained by the patient during treatment and local skin reactions can limit its use.

OBJECTIVES: To determine the efficacy and safety of combined PDT (daylight PDT followed by conventional PDT) vs. conventional PDT 12 weeks after treatment.

METHODS: The study was performed as a randomized, single-center, non-inferiority clinical trial with two parallel groups. A total of 51 patients with grade I and II AKs on the scalp or face were randomized. 25 patients received one session of combined PDT (combPDT) and 26 patients received one session of conventional PDT (cPDT). The primary endpoint was the reduction of AKs, 12 weeks after treatment. The secondary endpoint was the reduction in pain and local skin reaction.

RESULTS: The reduction rate of grade I and II AKs was similar in combPDT and cPDT, showing no statistically significant differences between both groups, 76.67% vs. 86.63% [p = 0.094] and 80.48% vs. 83.08% [p = 0.679], respectively. However, pain was significantly lower in the combPDT group (2.56 vs. 5, p < 0.01), as were local skin reactions.

CONCLUSIONS: CombPDT has proven to be as effective as cPDT for the treatment of grade I and II AKs located on the scalp and face. Furthermore, combPDT has been shown to be considerably more tolerable than cPDT, causing only mild local skin reactions.

PMID:34773302 | DOI:10.1111/phpp.12753

Vet Rec. 2021 Nov 12:e974. doi: 10.1002/vetr.974. Online ahead of print.

ABSTRACT

OBJECTIVE: Transmissable venereal tumour (TVT) is a tumour transplanted by physical contact between dogs. Lesions typically affect the genitalia. TVT is not considered enzootic in the United Kingdom (UK), with cases seen in imported dogs. We sought to determine the patient characteristics, temporal and spatial distribution and country of origin of affected dogs in the UK.

METHODS: Electronic pathology records (EPRs) from four UK veterinary diagnostic laboratories collected between 2010 and 2019 were searched for the terms ‘venereal’ or ‘TVT’. Reports were reviewed for statements confirming a TVT and descriptive statistics collated.

RESULTS: Of 182 EPRs matching the search terms, a diagnosis of TVT was confirmed in 71. Country of origin was noted in 36 cases (50.7%) with Romania being the most common (n = 29). Cases were reported in each UK constituent country, with the majority being in England (64, 90.1%). The incidence of TVT diagnosis increased over the last decade (z = 2.78, p = 0.005).

CONCLUSIONS/DISCUSSION: The incidence of TVT diagnosed in the UK is increasing. The majority of cases were known to have been imported. Autochthonous transmission cannot be excluded due to study design. Vets are encouraged to carefully examine the genitalia of dogs imported to the UK from countries with enzootic TVT.

PMID:34773267 | DOI:10.1002/vetr.974

Stat Med. 2021 Nov 12. doi: 10.1002/sim.9250. Online ahead of print.

ABSTRACT

The medium-throughput mRNA abundance platform NanoString nCounter has gained great popularity in the past decade, due to its high sensitivity and technical reproducibility as well as remarkable applicability to ubiquitous formalin fixed paraffin embedded (FFPE) tissue samples. Based on RCRnorm developed for normalizing NanoString nCounter data and Bayesian LASSO for variable selection, we propose a fully integrated Bayesian method, called RCRdiff, to detect differentially expressed (DE) genes between different groups of tissue samples (eg, normal and cancer). Unlike existing methods that often require normalization performed beforehand, RCRdiff directly handles raw read counts and jointly models the behaviors of different types of internal controls along with DE and non-DE gene patterns. Doing so would avoid efficiency loss caused by ignoring estimation uncertainty from the normalization step in a sequential approach and thus can offer more reliable statistical inference. We also propose clustering-based strategies for DE gene selection, which do not require any external dataset and are free of any arbitrary cutoff. Empirical evidence of the attractiveness of RCRdiff is demonstrated via extensive simulation and data examples.

PMID:34773277 | DOI:10.1002/sim.9250