Category: Nevin Manimala

IEEE J Biomed Health Inform. 2021 Oct 19;PP. doi: 10.1109/JBHI.2021.3120662. Online ahead of print.

ABSTRACT

Manual titration of positive airway pressure (PAP) is a gold standard to provide an optimal pressure for the treatment of obstructive sleep apnea-hypopnea syndrome (OSAS). Since manual titration studies were costly and time-consuming, many statistical models for predicting effective PAPs were reported. However, the prediction accuracies of the models associated with nocturnal parameters still remain low. This study proposes a fuzzy neural prediction network (FNPN) with input candidate variables, selected among easily available measurements (e.g., body mass index (BMI), waist circumstance (WC), and body composition) and OSAS related questionnaires, to rapidly predict an optimal PAP. The FNPN comprises fuzzy rules and is characterized with the ability of automatic rule growing and pruning from training data. A total of 147 participants from April 2018 to April 2019 were enrolled in Taichung Veterans General Hospital, Taiwan. After two selection processes for feature extraction, WC and BMI were the significant variables for entering the FNPN to predict optimal PAP. Experimental results showed that the average successful prediction rate of the proposed method was 71.8%. This study also found that Epworth sleepiness scales (ESS) and body composition, such as visceral fat area and percent body fat, were excluded in the final prediction model. Compared with existing models, the proposed prediction approach provided a rapid prediction of optimal PAP with higher accuracy.

PMID:34665745 | DOI:10.1109/JBHI.2021.3120662

J Water Health. 2021 Oct;19(5):762-774. doi: 10.2166/wh.2021.119.

ABSTRACT

Laguna Lake is an economically important resource in the Philippines, with reports of declining water quality due to fecal pollution. Currently, monitoring methods rely on counting fecal indicator bacteria, which does not supply information on potential sources of contamination. In this study, we predicted sources of Escherichia coli in lake stations and tributaries by establishing a fecal source library composed of rep-PCR DNA fingerprints of human, cattle, swine, poultry, and sewage samples (n = 1,408). We also evaluated three statistical methods for predicting fecal contamination sources in surface waters. Random forest (RF) outperformed k-nearest neighbors and discriminant analysis of principal components in terms of average rates of correct classification in two- (84.85%), three- (82.45%), and five-way (74.77%) categorical splits. Overall, RF exhibited the most balanced prediction, which is crucial for disproportionate libraries. Source tracking of environmental isolates (n = 332) revealed the dominance of sewage (47.59%) followed by human sources (29.22%), poultry (12.65%), swine (7.23%), and cattle (3.31%) using RF. This study demonstrates the promising utility of a library-dependent method in augmenting current monitoring systems for source attribution of fecal contamination in Laguna Lake. This is also the first known report of microbial source tracking using rep-PCR conducted in surface waters of the Laguna Lake watershed.

PMID:34665769 | DOI:10.2166/wh.2021.119

Clin Exp Rheumatol. 2021 Sep 28. Online ahead of print.

ABSTRACT

OBJECTIVES: We aimed to assess the performance of the 2015 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) gout classification criteria in an Italian cohort of patients with crystal-induced arthritis stratified by disease duration and gender in a real-life setting.

METHODS: Consecutive patients referred to Rheumatology Units for suspected acute crystal-induced arthritis were enrolled in a multicentre cohort study by the Italian Society of Rheumatology which was designed to improve the management of crystal-induced arthritis (ATTACk). To test the performance of the criteria (sensitivity and specificity), the presence of monosodium urate (MSU) crystals in synovial fluid (SF) was used as gold standard. Subgroup analyses by gender and disease duration were performed.

RESULTS: Two hundred and seventy-seven patients were enrolled. SF analysis was available in 137 (49%) patients. Complete SF analysis and ACR/EULAR scores were obtained in 44% of patients. MSU crystals were found in 66% of patients. The sensitivity and the specificity of all criteria sets were 78% (95%CI, 67-86) and 98% (95%CI, 87-100), respectively; only clinical criteria yielded 70% (95%CI, 59-80) sensitivity and 93% (95%CI, 80-98) specificity, respectively. In early-stage disease (<2 years), the sensitivity dropped to 58% (95%CI, 39-75), while the specificity was 100% (95%CI, 85-100).

CONCLUSIONS: The ACR/EULAR criteria showed good performance in patients presenting with acute arthritis; changes were observed when a subset of criteria were used, especially in early-stage disease.

PMID:34665701

Clin Exp Rheumatol. 2021 Oct 18. Online ahead of print.

ABSTRACT

OBJECTIVES: To identify ultrasound (US) features of lymphomas (L) of major salivary glands (SGs) in primary Sjögren’s syndrome (pSS) patients and to differentiate US pattern of L and non-L.

METHODS: prospectively, from September 2019 to March 2021, 27 pSS-patients with clinical findings suspicious for L of the SGs underwent US evaluation followed by US-guided core-needle biopsy (CNB). For each patient, we assessed the OMERACT score, dichotomised (0/1 “lower”, 2/3 “higher”), and we compared it between L-pSS and nonL-pSS groups. For focal lesions, echogenicity, inner appearance, shape, margins, presence of septa, vascularisation and posterior acoustic features were also assessed and compared between the two groups; we planned to consider as “suspicious” features more frequently associated with L. We expected to compare frequencies at which two or more “suspicious” features were simultaneously present between L-pSS and nonL-pSS. P<0.05 were considered statistically significant.

RESULTS: L-pSS showed more inhomogeneous glandular pattern (100% vs. 69.2% higher OMERACT; p=0.0407). For focal lesions, the “suspicious” features identified were: OMERACT grade 3, very hypoechoic, homogenous, oval shape, well-defined margins, presence of septa, colour-Doppler vascularization, posterior acoustic enhancement. 6/8 and 7/8 simultaneous suspicious features were significantly higher among L-pSS patients, compared to nonL-pSS (88.9% vs. 28.6%, p=0.034 for 6/8 features; 77.8% vs. 14.3%, p=0.040 for 7/8 features).

CONCLUSIONS: L of the major SGs in pSS was always associated with OMERACT scores 2 or 3 and presented with diffuse or focal patterns. For focal lesions, the association of more “suspicious” features made the diagnosis of L increasingly more likely. This information can help to improve planning of US-guided CNB.

PMID:34665707

Nat Commun. 2021 Oct 18;12(1):6071. doi: 10.1038/s41467-021-26282-z.

ABSTRACT

In contrast to the curative effect of allogenic stem cell transplantation in acute myeloid leukemia via T cell activity, only modest responses are achieved with checkpoint-blockade therapy, which might be explained by T cell phenotypes and T cell receptor (TCR) repertoires. Here, we show by paired single-cell RNA analysis and TCR repertoire profiling of bone marrow cells in relapsed/refractory acute myeloid leukemia patients pre/post azacytidine+nivolumab treatment that the disease-related T cell subsets are highly heterogeneous, and their abundance changes following PD-1 blockade-based treatment. TCR repertoires expand and primarily emerge from CD8⁺ cells in patients responding to treatment or having a stable disease, while TCR repertoires contract in therapy^–resistant patients. Trajectory analysis reveals a continuum of CD8⁺ T cell phenotypes, characterized by differential expression of granzyme B and a bone marrow-residing memory CD8⁺ T cell subset, in which a population with stem-like properties expressing granzyme K is enriched in responders. Chromosome 7/7q loss, on the other hand, is a cancer-intrinsic genomic marker of PD-1 blockade resistance in AML. In summary, our study reveals that adaptive T cell plasticity and genomic alterations determine responses to PD-1 blockade in acute myeloid leukemia.

PMID:34663807 | DOI:10.1038/s41467-021-26282-z

Nutr Diabetes. 2021 Oct 18;11(1):32. doi: 10.1038/s41387-021-00170-3.

ABSTRACT

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a strong risk factor for liver fibrosis in non-alcoholic fatty liver disease (NAFLD). It remains uncertain why T2DM increases the risk of liver fibrosis. It has been suggested that growth differentiation factor-15 (GDF-15) concentrations increase the risk of liver fibrosis. We aimed to investigate (a) whether GDF-15 concentrations were associated with liver fibrosis and involved in the relationship between T2DM and liver fibrosis and (b) what factors linked with T2DM are associated with increased GDF-15 concentrations.

METHODS: Ninety-nine patients with NAFLD (61% men, 42.4% T2DM) were studied. Serum GDF-15 concentrations were measured by electro-chemiluminescence immunoassay. Vibration-controlled transient elastography (VCTE)-validated thresholds were used to assess liver fibrosis. Regression modelling, receiver operator characteristic curve analysis and Sobel test statistics were used to test associations, risk predictors and the involvement of GDF-15 in the relationship between T2DM and liver fibrosis, respectively.

RESULTS: Patients with NAFLD and T2DM (n = 42) had higher serum GDF-15 concentrations [mean (SD): 1271.0 (902.1) vs. 640.3 (332.5) pg/ml, p < 0.0001], and a higher proportion had VCTE assessed ≥F2 fibrosis (48.8 vs. 23.2%, p = 0.01) than those without T2DM. GDF-15 was independently associated with liver fibrosis (p = 0.001), and GDF-15 was the most important single factor predicting ≥F2 or ≥F3 fibrosis (≥F2 fibrosis AUROC 0.75, (95% CI 0.63-0.86), p < 0.001, with sensitivity, specificity, positive predictive (PPV) and negative predictive (NPV) values of 56.3%, 86.9%, 69.2% and 79.1%, respectively). GDF-15 was involved in the association between T2DM and ≥F2 fibrosis (Sobel test statistic 2.90, p = 0.004). Other factors associated with T2DM explained 60% of the variance in GDF-15 concentrations (p < 0.0001). HbA1c concentrations alone explained 30% of the variance (p < 0.0001).

CONCLUSIONS: GDF-15 concentrations are a predictor of liver fibrosis and potentially involved in the association between T2DM and liver fibrosis in NAFLD. HbA1c concentrations explain a large proportion of the variance in GDF-15 concentrations.

PMID:34663793 | DOI:10.1038/s41387-021-00170-3

Nat Commun. 2021 Oct 18;12(1):6073. doi: 10.1038/s41467-021-26246-3.

ABSTRACT

Large-scale profiling of intact glycopeptides is critical but challenging in glycoproteomics. Data independent acquisition (DIA) is an emerging technology with deep proteome coverage and accurate quantitative capability in proteomics studies, but is still in the early stage of development in the field of glycoproteomics. We propose GproDIA, a framework for the proteome-wide characterization of intact glycopeptides from DIA data with comprehensive statistical control by a 2-dimentional false discovery rate approach and a glycoform inference algorithm, enabling accurate identification of intact glycopeptides using wide isolation windows. We further utilize a semi-empirical spectrum prediction strategy to expand the coverage of spectral libraries of glycopeptides. We benchmark our method for N-glycopeptide profiling on DIA data of yeast and human serum samples, demonstrating that DIA with GproDIA outperforms the data-dependent acquisition-based methods for glycoproteomics in terms of capacity and data completeness of identification, as well as accuracy and precision of quantification. We expect that this work can provide a powerful tool for glycoproteomic studies.

PMID:34663801 | DOI:10.1038/s41467-021-26246-3

Uisahak. 2021 Aug;30(2):355-392. doi: 10.13081/kjmh.2021.30.355.

ABSTRACT

The anti-cholera measures of 1969-70 represent one of the most unsuccessful quarantine cases in modern Korea. The military government, which overthrew the democratic government in 1961, tried to amend the Constitution aiming for a long-term seizure of power, and had to overcome the cholera crisis of 1969-70. Previous scholarship has emphasized the limitation of the state power when it came to controlling the cholera epidemic or the poor sanitation system of 1969-70. However, it is undeniable that the military government did have organizations, facilities, and human capital available. When a cholera epidemic broke out in 1963-64, the military government defended its people against cholera as part of the Revolutionary Tasks. Furthermore, it took counsel from a team of medical professionals knowledgeable in microbiology. In 1969, the possibility of bacteriological warfare by North Korea emerged while the government responded to cholera. To avoid this crisis, Park Chŏng-hŭi’s military government, which had been preparing for longterm rule, had to provide successful model in the cholera defense. For the military government, the concealment and distortion of infectious disease information was inevitable. Many other medical professionals trusted the activities of international organizations more than they did the government bodies, and the media accused the government of fabricating cholera death statistics. As the government failed to prevent the cholera crisis, it tightened its secrecy by concealing facts and controlling information.

PMID:34663775 | DOI:10.13081/kjmh.2021.30.355

Uisahak. 2021 Aug;30(2):221-275. doi: 10.13081/kjmh.2021.30.221.

ABSTRACT

Uiyeokju Palsebo is a genealogy record that contains the eighth generation of patrilineal ancestors, maternal grandfathers, and fathers-in-law of technical officials who worked in three fields: medicine, linguistics, and mathematics. This book covers members of influential families who monopolized the positions of technical officers. In that respect, it seems to have had an effect like a kind of ‘white list’. This paper identifies the range of families based on common ancestors above eight generations according to the editing method of this book, attempting various statistical analysis. The results of the analysis shows that it is possible to determine the size of the medical families, which varied according to the number of medical bureaucrats and the distance of kinship between them. Most of the families had workers in the three fields of medicine, linguistics, and mathematics, but there were also ‘families more specialized in medicine’ that produced a large number of medical figures. The ancestors of medical figures were mainly engaged in the three fields of medicine, linguistics, and mathematics, but there were also a small number of officials in charge of “unhak(including astronomy, geography, and fortune-telling),” law, art, and transcription. For distant ancestors from common ancestors to the fifth generation, the proportion of technical officers was small, but for relatively close ancestors, the proportion of technical officers, especially medical officers, increased. It can be seen that the status as a medical officer tends to be hereditary further down the generations. The fields of activity of the maternal grandfathers and fathers-in-law of medical figures were more concentrated in the medical field. This can be the result of confirming the influence of the marital relationship network that was formed in the close period with the medical persons being investigated. In this paper, only medical figures were considered as primary research subjects, but their macroscopic networks were relatively evenly spread out in the three fields of medicine, linguistics, and mathematics. In this network, Uiyeokju Palsebo contained homogeneous hierarchies that could continuously dominate a specific field of government office.

PMID:34663772 | DOI:10.13081/kjmh.2021.30.221

Proc Natl Acad Sci U S A. 2021 Oct 26;118(43):e2114679118. doi: 10.1073/pnas.2114679118.

ABSTRACT

An important idea underlying a plausible dynamical theory of circulation in three-dimensional turbulence is the so-called area rule, according to which the probability density function (PDF) of the circulation around closed loops depends only on the minimal area of the loop, not its shape. We assess the robustness of the area rule, for both planar and nonplanar loops, using high-resolution data from direct numerical simulations. For planar loops, the circulation moments for rectangular shapes match those for the square with only small differences, these differences being larger when the aspect ratio is farther from unity and when the moment order increases. The differences do not exceed about 5% for any condition examined here. The aspect ratio dependence observed for the second-order moment is indistinguishable from results for the Gaussian random field (GRF) with the same two-point correlation function (for which the results are order-independent by construction). When normalized by the SD of the PDF, the aspect ratio dependence is even smaller ( < 2%) but does not vanish unlike for the GRF. We obtain circulation statistics around minimal area loops in three dimensions and compare them to those of a planar loop circumscribing equivalent areas, and we find that circulation statistics match in the two cases only when normalized by an internal variable such as the SD. This work highlights the hitherto unknown connection between minimal surfaces and turbulence.

PMID:34663734 | DOI:10.1073/pnas.2114679118