Category: Nevin Manimala

Eur J Cancer. 2021 Jul 14;154:138-146. doi: 10.1016/j.ejca.2021.06.010. Online ahead of print.

ABSTRACT

BACKGROUND: In the ARAMIS trial, darolutamide plus androgen deprivation therapy (ADT) versus placebo plus ADT significantly improved metastasis-free survival (MFS), overall survival (OS) and time to pain progression in patients with non-metastatic castration-resistant prostate cancer (nmCRPC). Herein, we present analyses of patient-reported health-related quality of life (HRQoL) outcomes.

PATIENTS AND METHODS: This double-blind, placebo-controlled, phase III trial randomised patients with nmCRPC and prostate-specific antigen doubling time ≤10 months to darolutamide 600 mg (n = 955) twice daily or matched placebo (n = 554) while continuing ADT. The primary end-point was MFS; the secondary end-points included OS and time to pain progression. In this analysis, HRQoL was assessed by the time to deterioration using the Functional Assessment of Cancer Therapy-Prostate (FACT-P) prostate cancer subscale (PCS) and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Prostate Cancer Module (EORTC QLQ-PR25) subscales.

RESULTS: Darolutamide significantly prolonged time to deterioration of FACT-P PCS versus placebo (hazard ratio [HR] 0.80, 95% confidence interval [CI] 0.70-0.91; P = 0.0005) at the primary analysis (cut-off date: 3rd September 2018). Time to deterioration of EORTC QLQ-PR25 outcomes showed statistically significant delays with darolutamide versus placebo for urinary (HR 0.64, 95% CI 0.54-0.76; P < 0.0001) and bowel (HR 0.78, 95% CI 0.66-0.92; P = 0.0027) symptoms. Time to worsening of hormonal treatment-related symptoms was similar between the two groups.

CONCLUSION: In patients with nmCRPC who are generally asymptomatic, darolutamide maintained HRQoL by significantly delaying time to deterioration of prostate cancer-specific quality of life and disease-related symptoms versus placebo.

PMID:34273811 | DOI:10.1016/j.ejca.2021.06.010

J Surg Res. 2021 Jul 14;267:636-641. doi: 10.1016/j.jss.2021.06.022. Online ahead of print.

ABSTRACT

INTRODUCTION: Pre-operative hemoglobin (Hb) A1c levels ≥ 8% can lead to increased post-operative complications. In bariatric surgery patients, attaining a pre-operative HbA1c < 8% can be a challenge. The purpose of this study was to identify the association of pre-operative HbA1c on post-operative outcomes in bariatric surgery patients.

MATERIAL AND METHODS: A retrospective chart review was conducted on diabetic patients (HbA1c ≥ 6.5%) who underwent primary bariatric surgery at a single institution between the years 2013 and 2019. Patients were divided into two groups based on their pre-operative HbA1c levels of < 8% and ≥ 8%. Univariate analyses were performed to determine an association between pre-operative HbA1c levels and post-operative outcomes.

RESULTS: There were 351 primary diabetic bariatric surgery patients, 270 HbA1c <8%, and 81 HbA1c ≥ 8%. Procedure selection was significantly different between the HbA1c < 8% and HbA1c ≥ 8% group (49.3% sleeve, 50.4% bypass and 0.4% band versus 43.2% sleeve, 53.1% bypass and 3.7% band respectively, P < 0.04). There was no statistically significant difference in any 30-day post-operative outcome between the two groups. Post-operative HbA1c was significantly less in the HbA1c < 8% group at 3-6 month (6.0% ± 0.9 versus 7.4% ± 1.4, P <0.001) and 6-12 month (6.0% ± 1.1 versus 7.2% ± 1.4, P <0.001) follow-up.

CONCLUSIONS: This study demonstrated no difference in post-operative outcomes of primary bariatric surgery patients based on a HbA1c cut-off of 8%. This highlights that bariatric surgery can be considered and safely performed in patients with a pre-operative HbA1c ≥ 8%.

PMID:34273793 | DOI:10.1016/j.jss.2021.06.022

Cortex. 2021 Jun 23;142:186-203. doi: 10.1016/j.cortex.2021.05.020. Online ahead of print.

ABSTRACT

Laughter is a fundamental communicative signal in our relations with other people and is used to convey a diverse repertoire of social and emotional information. It is therefore potentially a useful probe of impaired socio-emotional signal processing in neurodegenerative diseases. Here we investigated the cognitive and affective processing of laughter in forty-seven patients representing all major syndromes of frontotemporal dementia, a disease spectrum characterised by severe socio-emotional dysfunction (twenty-two with behavioural variant frontotemporal dementia, twelve with semantic variant primary progressive aphasia, thirteen with nonfluent-agrammatic variant primary progressive aphasia), in relation to fifteen patients with typical amnestic Alzheimer’s disease and twenty healthy age-matched individuals. We assessed cognitive labelling (identification) and valence rating (affective evaluation) of samples of spontaneous (mirthful and hostile) and volitional (posed) laughter versus two auditory control conditions (a synthetic laughter-like stimulus and spoken numbers). Neuroanatomical associations of laughter processing were assessed using voxel-based morphometry of patients’ brain MR images. While all dementia syndromes were associated with impaired identification of laughter subtypes relative to healthy controls, this was significantly more severe overall in frontotemporal dementia than in Alzheimer’s disease and particularly in the behavioural and semantic variants, which also showed abnormal affective evaluation of laughter. Over the patient cohort, laughter identification accuracy was correlated with measures of daily-life socio-emotional functioning. Certain striking syndromic signatures emerged, including enhanced liking for hostile laughter in behavioural variant frontotemporal dementia, impaired processing of synthetic laughter in the nonfluent-agrammatic variant (consistent with a generic complex auditory perceptual deficit) and enhanced liking for numbers (‘numerophilia’) in the semantic variant. Across the patient cohort, overall laughter identification accuracy correlated with regional grey matter in a core network encompassing inferior frontal and cingulo-insular cortices; and more specific correlates of laughter identification accuracy were delineated in cortical regions mediating affective disambiguation (identification of hostile and posed laughter in orbitofrontal cortex) and authenticity (social intent) decoding (identification of mirthful and posed laughter in anteromedial prefrontal cortex) (all p < .05 after correction for multiple voxel-wise comparisons over the whole brain). These findings reveal a rich diversity of cognitive and affective laughter phenotypes in canonical dementia syndromes and suggest that laughter is an informative probe of neural mechanisms underpinning socio-emotional dysfunction in neurodegenerative disease.

PMID:34273798 | DOI:10.1016/j.cortex.2021.05.020

Eur J Obstet Gynecol Reprod Biol. 2021 Jul 7;264:60-64. doi: 10.1016/j.ejogrb.2021.07.009. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate concordance between prenatal and postnatal diagnosis of congenital talipes equinovarus (cTEV), rates of surgery and postnatal outcomes in relation to the prenatal classification of severity.

STUDY DESIGN: This is a retrospective observational cohort study on fetuses with a prenatal diagnosis of cTEV between 2004 and 2018. All cases of isolated cTEV in singleton pregnancies were included. Postnatally, the Ponseti method was applied. Children were followed-up postnatally for at least two years, with a specific focus on neurodevelopmental outcome.

RESULTS: The cohort included 81 fetuses with a prenatal diagnosis of cTEV confirmed postnatally in 86.4% of cases. Concordance between prenatal and postnatal assessment was good for both laterality and degree of severity (k = 0.61 and 0.66, respectively). The average Pirani score, number of casts and rates of Achilles tendon tenotomy were higher for III degree cTEV (p < 0.001). Within this group only, the rate of relapse was 11% and the rates of major surgery was 6%. The postnatal outcome was normal in 68.6% newborns, while 14% of cases had a diagnosis of minor additional findings and 17% had an impairment of neurological development. None of the outcome was statistically correlated to the prenatal assessment of laterality or degree.

CONCLUSIONS: The accuracy of prenatal ultrasound for isolated cTEV is 86% with a false positive diagnosis of 14%. The grade of cTEV assigned prenatally correlates to postnatal severity and longer orthopedic rehabilitation in terms of number of casts and need of surgery. The assessment of the correlation between cTEV and neurological impairment requires further prospective studies on larger cohorts.

PMID:34273754 | DOI:10.1016/j.ejogrb.2021.07.009

Environ Pollut. 2021 Jul 7;288:117713. doi: 10.1016/j.envpol.2021.117713. Online ahead of print.

ABSTRACT

In recent decades China has experienced high-level PM_2.5 pollution and then visible air quality improvement. To understand the air quality change from the perspective of aerosol optical depth (AOD), we adopted two statistical methods of Empirical Orthogonal Functions (EOF) and Non-negative Matrix Factorization (NMF) to AOD retrieved by MODIS over China and surrounding areas. Results showed that EOF and NMF identified the important factors influencing AOD over China from different angles: natural dusts controlled the seasonal variation with contribution of 42.4%, and anthropogenic emissions have larger contribution to AOD magnitude. To better observe the interannual variation of different sources, we removed seasonal cycles from original data and conducted EOF analysis on AOD monthly anomalies. Results showed that aerosols from anthropogenic sources had the greatest contribution (27%) to AOD anomaly variation and took an obvious downward trend, and natural dust was the second largest contributor with contribution of 17%. In the areas surrounding China, the eastward aerosol transport due to prevailing westerlies in spring significantly influenced the AOD variation over West Pacific with the largest contribution of 21%, whereas the aerosol transport from BTH region in winter had relative greater impact on the AOD magnitude. After removing seasonal cycles, biomass burning in South Asia became the most important influencing factor on AOD anomalies with contribution of 10%, as its interannual variability was largely affected by El Niño. Aerosol transport from BTH was the second largest contributor with contribution of 8% and showed a decreasing trend. This study showed that the downward trend of AOD over China since 2011 was dominated by aerosols from anthropogenic sources, which in a way confirmed the effectiveness of air pollution control policies.

PMID:34273768 | DOI:10.1016/j.envpol.2021.117713

Epilepsy Behav. 2021 Jul 14;122:108190. doi: 10.1016/j.yebeh.2021.108190. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the longitudinal impact of highly purified cannabidiol (CBD) on the electroencephalogram (EEG) of children and adults.

METHODS: Participants received an EEG prior to starting CBD, after approximately 12 weeks of CBD (FU1) and after approximately one year of CBD therapy (FU2). Longitudinal changes in five EEG measures (background frequency, focal slowing, reactivity, frequency of interictal, and ictal discharges) were examined following CBD exposure. Data were compared between pediatric and adult groups at two follow-up time points and within groups over time. Population-averaged models with generalized estimation equations or linear mixed effects models were used to analyze data where appropriate. Correlation analysis was used to assess any association between changes in seizure frequency and changes in EEG interictal discharge (IED) frequency. An alpha level of 5% was used to assess statistical significance.

RESULTS: At FU1, the adult group showed significant decrease in IED/minute (IDR 0.07, 95% CI [0.04, 0.14], P < 0.001); a nonsignificant decrease was observed among children (IDR 0.87, 95% CI [0.47, 0.64], P = 0.67). The difference in changes over time between participant groups was significant after adjusting for last CBD dose (IDR 11.8, 95% CI [4.86, 28.65], P < 0.0001). At FU2 both groups showed significant reduction from baseline after controlling for last CBD dose. This decrease was more pronounced in children (IDR 15.38, 95% CI [4.93, 47.99], P < 0.001). There was no significant correlation between changes in seizure frequency and EEG IED frequency at each timepoint (P = 0.542, 0.917 and 0.989 from baseline to FU1, FU1 to FU2 and baseline to FU2, respectively).

SIGNIFICANCE: This longitudinal EEG study shows that highly-purified plant-derived CBD has positive effects on interictal epileptiform discharge frequency but no effects on other EEG measures. The effect of CBD does not appear to be dose or treatment-duration dependent.

PMID:34273739 | DOI:10.1016/j.yebeh.2021.108190

Adv Med Sci. 2021 Jul 14;66(2):326-335. doi: 10.1016/j.advms.2021.07.003. Online ahead of print.

ABSTRACT

PURPOSE: Renal cell carcinoma (RCC) is a very aggressive and often fatal heterogeneous disease that is usually asymptomatic until late in the disease. There is an urgent need for RCC specific biomarkers that may be exploited clinically for diagnostic and prognostic purposes.

MATERIALS/METHODS: Serum and urine samples were collected from patients with diagnosed kidney cancer and assessed with gold nanoparticle enhanced target (AuNPET) surface assisted-laser desorption/ionization mass spectrometry (SALDI MS) based metabolomics and statistical analysis.

RESULTS: A database search allowed providing assignment of signals for the most promising features with a satisfactory value of the area under the curve and accuracy. Four potential biomarkers were found in urine and serum samples to distinguish clear cell renal cell carcinoma (ccRCC) from controls, 4 for the ccRCC with and without metastases, and 6 metabolites to distinguish low and high stages or grades.

CONCLUSIONS: This pilot study suggests that serum and urine metabolomics based on AuNPET-LDI MS may be useful in distinguishing types, grades and stages of human RCC.

PMID:34273747 | DOI:10.1016/j.advms.2021.07.003

J Electromyogr Kinesiol. 2021 Jul 10;60:102572. doi: 10.1016/j.jelekin.2021.102572. Online ahead of print.

ABSTRACT

PURPOSE: To compare the responses in knee joint muscle activation patterns to different perturbations during gait in healthy subjects.

SCOPE: Nine healthy participants were subjected to perturbed walking on a split-belt treadmill. Four perturbation types were applied, each at five intensities. The activations of seven muscles surrounding the knee were measured using surface EMG. The responses in muscle activation were expressed by calculating mean, peak, co-contraction (CCI) and perturbation responses (PR) values. PR captures the responses relative to unperturbed gait. Statistical parametric mapping analysis was used to compare the muscle activation patterns between conditions.

RESULTS: Perturbations evoked only small responses in muscle activation, though higher perturbation intensities yielded a higher mean activation in five muscles, as well as higher PR. Different types of perturbation led to different responses in the rectus femoris, medial gastrocnemius and lateral gastrocnemius. The participants had lower CCI just before perturbation compared to the same phase of unperturbed gait.

CONCLUSIONS: Healthy participants respond to different perturbations during gait with small adaptations in their knee joint muscle activation patterns. This study provides insights in how the muscles are activated to stabilize the knee when challenged. Furthermore it could guide future studies in determining aberrant muscle activation in patients with knee disorders.

PMID:34273728 | DOI:10.1016/j.jelekin.2021.102572

Nurse Educ Pract. 2021 Jun 30;55:103140. doi: 10.1016/j.nepr.2021.103140. Online ahead of print.

ABSTRACT

AIM: To improve undergraduate nursing students and educator intercultural knowledge and competencies by implementing an academic systems change.

BACKGROUND: Many organizations have diversity and inclusion guidelines and initiatives for healthcare providers to consider in determining culturally competent care, which has a direct impact on the care given, received, and overall outcomes.

DESIGN: 1. Assess student’s mindset at the beginning and the end of an undergraduate nursing course. 2. Ensure diversity and inclusion content was provided to faculty through a continuing education program. 3. Review all undergraduate courses for diversity and inclusion content.

METHODS: The Intercultural Development Inventory®, a 50-item cross-cultural, theory-based assessment tool was used in a pre- and post-test design (n = 61 intervention; n = 56 control) to determine undergraduate nursing student’s mindset and assists the student’s in developing a personalized Intercultural Development Plan. The effectiveness of faculty diversity and inclusion education was evaluated using a post program evaluation. Curricular blueprinting of all undergraduate nursing courses for diversity and inclusion content was completed.

RESULTS: The results demonstrated a statistically significant difference in the post-test between the intervention and control groups.

CONCLUSION: While evidence is lacking in specificity of how to best implement diversity and inclusion content in curriculum, these results provided some excellent baseline data that can be tracked while continued changes occur.

PMID:34273730 | DOI:10.1016/j.nepr.2021.103140

Neural Netw. 2021 Jun 30;143:452-474. doi: 10.1016/j.neunet.2021.06.022. Online ahead of print.

ABSTRACT

Accurate characterization of brain activity during a cognitive task is challenging due to the dynamically changing and the complex nature of the brain. The majority of the proposed approaches assume stationarity in brain activity and disregard the systematic timing organization among brain regions during cognitive tasks. In this study, we propose a novel cognitive activity recognition method that captures the activity-specific timing parameters from training data that elicits maximal average short-lived pairwise synchronization between electroencephalography signals. We evaluated the characterization power of the activity-specific timing parameter triplets in a motor imagery activity recognition framework. The activity-specific timing parameter triplets consist of latency of the maximally synchronized signal segments from activity onset Δt, the time lag between maximally synchronized signal segments τ, and the duration of the maximally synchronized signal segments w. We used cosine-based similarity, wavelet bi-coherence, phase-locking value, phase coherence value, linearized mutual information, and cross-correntropy to calculate the channel synchronizations at the specific timing parameters. Recognition performances as well as statistical analyses on both BCI Competition-III dataset IVa and PhysioNet Motor Movement/Imagery dataset, indicate that the inter-channel short-lived synchronization calculated using activity-specific timing parameter triplets elicit significantly distinct synchronization profiles for different motor imagery tasks and can thus reliably be used for cognitive task recognition purposes.

PMID:34273721 | DOI:10.1016/j.neunet.2021.06.022