Category: Statistics

AIDS Behav. 2023 Dec 13. doi: 10.1007/s10461-023-04220-y. Online ahead of print.

ABSTRACT

Improvement in treatment options has increased the survival of people living with HIV (PLHIV). Thus, we evaluated the factors associated with better health-related quality of life (HRQoL) among PLHIV in Brazil. This was a cross-sectional study carried out among 349 PLHIV. Data were collected using an interview-based questionnaire, and HRQoL was assessed by the Brazilian version of the WHOQOL HIV BREF instrument. We used non-hierarchical cluster analysis (K-means) to compile the WHOQOL HIV BREF’s overall and domain scores into a unique more multidimensional measure for HRQoL consisting of three clusters: poor, fair and good; associations with clusters of better HRQoL were assessed using multinomial logistic regression models. The mean and median overall HRQoL scores were 15.13 (SD = 3.39) and 16, respectively. The reliability and validity of the Brazilian version of the WHOQOL HIV BREF instrument was confirmed among PLHIV in a non-metropolitan, medium-sized municipality of Brazil, which reaffirmed the cross-cultural validity of this instrument. The factors male sex; heterosexual and asexual orientations; higher individual income; undetectable viral load; absence of any comorbidity and presence of an infectious or a chronic comorbidity, with mental illness as the reference; and never having consumed illegal substances were independently associated with good HRQoL. Thus, the compilation of the WHOQOL HIV BREF’s overall and domain scores into a unique multidimensional measure for HRQoL, which this study proposed for the first time, may facilitate more robust interpretations and models of predictors. These differentials could simplify HRQoL as an indicator of health and wellbeing to be routinely used as a key outcome in the clinical management of patients and in the global monitoring of health system responses to HIV.

PMID:38087154 | DOI:10.1007/s10461-023-04220-y

Brain Imaging Behav. 2023 Dec 12. doi: 10.1007/s11682-023-00835-w. Online ahead of print.

ABSTRACT

To comprehensively investigate the potential temporal dynamic and static abnormalities of spontaneous brain activity (SBA) in left temporal lobe epilepsy (LTLE) and right temporal lobe epilepsy (RTLE) and to detect whether these alterations correlate with cognition. Twelve SBA metrics, including ALFF, dALFF, fALFF, dfALFF, ReHo, dReHo, DC, dDC, GSCorr, dGSCorr, VMHC, and dVMHC, in 46 LTLE patients, 43 RTLE patients, and 53 healthy volunteers were compared in the voxel-wise analysis. Correlation analyses between metrics in regions showing statistic differences and epilepsy duration, epilepsy severity, and cognition scores were also performed. Compared with the healthy volunteers, the alteration of SBA was identified both in LTLE and RTLE patients. The ALFF, fALFF, and dALFF values in LTLE, as well as the fALFF values in RTLE, increased in the bilateral thalamus, basal ganglia, mesial temporal lobe, cerebellum, and vermis. Increased dfALFF in the bilateral basal ganglia, increased ReHo and dReHo in the bilateral thalamus in the LTLE group, increased ALFF and dALFF in the pons, and increased ReHo and dReHo in the right hippocampus in the RTLE group were also detected. However, the majority of deactivation clusters were in the ipsilateral lateral temporal lobe. For LTLE, the fALFF, DC, dDC, and GSCorr values in the left lateral temporal lobe and the ReHo and VMHC values in the bilateral lateral temporal lobe all decreased. For RTLE, the ALFF, fALFF, dfALFF, ReHo, dReHo, and DC values in the right lateral temporal lobe and the VMHC values in the bilateral lateral temporal lobe all decreased. Moreover, for both the LTLE and RTLE groups, the dVMHC values decreased in the calcarine cortex. The most significant difference between LTLE and RTLE was the higher activation in the cerebellum of the LTLE group. The alterations of many SBA metrics were correlated with cognition and epilepsy duration. The patterns of change in SBA abnormalities in the LTLE and RTLE patients were generally similar. The integrated application of temporal dynamic and static SBA metrics might aid in the investigation of the propagation and suppression pathways of seizure activity as well as the cognitive impairment mechanisms in TLE.

PMID:38087148 | DOI:10.1007/s11682-023-00835-w

Parasitol Res. 2023 Dec 13;123(1):33. doi: 10.1007/s00436-023-08040-w.

ABSTRACT

Fasciolosis is a zoonosis that limits the productivity of ruminants worldwide, but there is a lack of information on its occurrence in Burundi. Therefore, this study aimed to fill the information gap by determining the prevalence and risk factors associated with bovine fasciolosis in the Imbo Region of Burundi. Two prevalence studies were conducted in parallel in the five communes of the five provinces in the Imbo region. In the first study, a total of 426 fecal samples were collected from randomly selected cattle farms and microscopically examined to determine Fasciola egg burden. Survey data on cattle husbandry were collected from owners of these cattle and analyzed to determine the risk factors for bovine fasciolosis. In the second study, 467 cattle were randomly selected in abattoirs and their livers were examined postmortem to determine liver fluke burdens. Data were entered separately into Microsoft Excel and analyzed using R software. The overall prevalence of bovine fasciolosis was 47.7% (42.9-52.4, 95% CI) for microscopic examination and 33.2% (28.9-37.5, 95% CI) for postmortem examinations. The majority of positive cattle (60.6%) had light intensity infections as determined by eggs per gram of feces (epg). Postmortem examinations corroborated these results and indicated that 80% of cattle had light intensity infections. Chi-square analysis showed a statistical association with the presence of bovine fasciolosis and the age, sex, and origin of cattle and the practices of cattle owners (P < 0.05).

PMID:38087118 | DOI:10.1007/s00436-023-08040-w

Nat Med. 2023 Dec 12. doi: 10.1038/s41591-023-02601-3. Online ahead of print.

ABSTRACT

To support a strategy to eliminate cervical cancer as a public health problem, the World Health Organisation (WHO) reviewed its guidelines for screening and treatment of cervical pre-cancerous lesions in 2021. Women living with HIV have 6-times the risk of cervical cancer compared to women in the general population, and we harnessed a model platform (‘Policy1-Cervix-HIV’) to evaluate the benefits and harms of a range of screening strategies for women living with HIV in Tanzania, a country with endemic HIV. Assuming 70% coverage, we found that 3-yearly primary HPV screening without triage would reduce age-standardised cervical cancer mortality rates by 72%, with a number needed to treat (NNT) of 38.7, to prevent a cervical cancer death. Triaging HPV positive women before treatment resulted in minimal loss of effectiveness and had more favorable NNTs (19.7-33.0). Screening using visual inspection with acetic acid (VIA) or cytology was less effective than primary HPV and, in the case of VIA, generated a far higher NNT of 107.5. These findings support the WHO 2021 recommendation that women living with HIV are screened with primary HPV testing in a screen-triage-and-treat approach starting at 25 years, with regular screening every 3-5 years.

PMID:38087116 | DOI:10.1038/s41591-023-02601-3

J Prev (2022). 2023 Dec 12. doi: 10.1007/s10935-023-00756-w. Online ahead of print.

ABSTRACT

Predictors of hypertension (HTN) control status have not been well understood in India. This information is crucial for policymakers and program managers to devise newer HTN control strategies and implement relevant policies and programs. Therefore, we undertook this meta-analysis to estimate the effect of various factors on the control status of HTN in India. We systematically searched PubMed and Embase for observational studies and community-based trials published between April 2013 and March 2021 conducted among people (≥ 15 years) with hypertension in India. Quality of studies was assessed using Newcastle Ottawa (NO) scale. Meta-analysis was performed using random effects model. We reported the effect of various factors on the prevalence of controlled HTN using pooled odds ratio (OR) with 95% confidence interval (CI). Of the 842 studies screened, we analyzed nine studies that included 2,441 individuals. Based on the NO scale, majority (90%) of studies had a low risk of bias. The odds of having controlled HTN were significantly higher among women (OR 1.78, 95% CI 1.62-1.95), those aged > 45 years (OR 1.69, 95% CI 1.44-1.97), and those residing in urban parts of India (OR 1.74; 95% CI 1.48-2.03). These measures varied considerably across different regions of the country. Very few studies reported data on the relationship between behavioural risk factors of non-communicable diseases (NCDs) and HTN control status. We did not find any statistically significant differences between behavioural risk factors of NCDs and HTN control status. To improve HTN control in India, the ongoing/newer HTN control programs need to target men, those aged 15-45, and rural residents. Future studies on HTN control determinants should report disaggregated data and use standardized definitions for behavioral risk factors to enhance reliability and comprehensiveness of findings on the determinants of HTN control in future reviews.

PMID:38087106 | DOI:10.1007/s10935-023-00756-w

Nat Struct Mol Biol. 2023 Dec;30(12):1947-1957. doi: 10.1038/s41594-023-01161-x. Epub 2023 Dec 12.

ABSTRACT

JTE-607 is an anticancer and anti-inflammatory compound and its active form, compound 2, directly binds to and inhibits CPSF73, the endonuclease for the cleavage step in pre-messenger RNA (pre-mRNA) 3′ processing. Surprisingly, compound 2-mediated inhibition of pre-mRNA cleavage is sequence specific and the drug sensitivity is predominantly determined by sequences flanking the cleavage site (CS). Using massively parallel in vitro assays, we identified key sequence features that determine drug sensitivity. We trained a machine learning model that can predict poly(A) site (PAS) relative sensitivity to compound 2 and provide the molecular basis for understanding the impact of JTE-607 on PAS selection and transcription termination genome wide. We propose that CPSF73 and associated factors bind to the CS region in a sequence-dependent manner and the interaction affinity determines compound 2 sensitivity. These results have not only elucidated the mechanism of action of JTE-607, but also unveiled an evolutionarily conserved sequence specificity of the mRNA 3′ processing machinery.

PMID:38087090 | DOI:10.1038/s41594-023-01161-x

J Cancer Educ. 2023 Dec 12. doi: 10.1007/s13187-023-02390-w. Online ahead of print.

ABSTRACT

There is a paucity of formalized exposure to Radiation Oncology (RO) for preclinical medical students across the United States as well as barriers to implementation within undergraduate medical education curriculum at many institutions. We present a novel approach to implementing an introductory RO didactic lecture to second-year medical students by interweaving associated oncological and ionizing radiation content represented on the United States Medical Licensing Exam® (USMLE®) Step 1 examination. Students had synchronous and asynchronous opportunities to engage with the 1.0-h didactic lecture administered by an attending Radiation Oncologist faculty member. Students were electronically invited to anonymously rank the effectiveness of the lecture materials on a 5-point Likert scale. Performance on standardized board-style questions regarding radiation biology and radiation side effects was recorded before and after the lecture and compared to the historic performance of previous institutional second-year medical student cohorts. The lecture material effectiveness received a mean score of 4.50 on a 5-point Likert scale. There was a statistically significant improvement in student performance on a board-style radiation side effect question from 39% on a pretest to 76% on a posttest. A USMLE® topic-based approach may be an effective way to implement a formalized introduction to RO to preclinical medical students while simultaneously improving performance on relevant standardized board-style questions. Providing evidence that RO topics appear on the USMLE® Step 1 examination curriculum was a powerful incentive for implementation when negotiating with curriculum offices.

PMID:38087075 | DOI:10.1007/s13187-023-02390-w

Neurosurg Rev. 2023 Dec 13;47(1):11. doi: 10.1007/s10143-023-02247-2.

ABSTRACT

Fusiform aneurysms of the anterior cerebral artery (ACA) are uncommon, and the natural history of this entity is poorly characterized. Along with our center experience, we conducted a systematic literature review to help shed light on the clinical course of ACA fusiform aneurysms. We queried our institutional database to identify cases with fusiform aneurysms of ACA. In addition, following the PRISMA algorithm, we identified all reported cases published in the English literature from the inception of PubMed until December 2022. We categorized clinical presentations into three categories: (i) traumatic/iatrogenic, (ii) spontaneous symptomatic ruptured/unruptured, and (iii) spontaneous asymptomatic aneurysms. We utilized descriptive statistics. We identified seven cases from our center along with 235 patients from published literature. Blunt trauma was responsible for the development of 19 aneurysms. Sixty-three percent of these aneurysms tend to rupture within 2 weeks from the initial trauma, and despite treatment, only 74% of these patients had good clinical outcomes. Spontaneous symptomatic presentation occurred in 207 patients and was often associated with previous/concomitant ACA dissection. Subarachnoid hemorrhage from ruptured aneurysms was the most common presentation. Spontaneous symptomatic fusiform aneurysm is rapidly evolving lesions, and treatment is necessary. Three of our own cases were treated with an endovascular flow diverter (pipeline) stenting with good outcomes. Spontaneous asymptomatic aneurysms were reported in nine patients. These lesions are often associated with other vascular abnormalities. Treatment included surgical clipping with good clinical outcomes. Instead, four patients from our center database were managed conservatively with equally good outcomes. Our study demonstrates good clinical outcomes when fusiform aneurysms of ACA, especially when symptomatic, are treated promptly with either reconstructive or deconstructive therapies.

PMID:38087068 | DOI:10.1007/s10143-023-02247-2

Breast Cancer Res Treat. 2023 Dec 12. doi: 10.1007/s10549-023-07193-7. Online ahead of print.

ABSTRACT

PURPOSE: Unnecessary axillary surgery can potentially be avoided in patients with DCIS undergoing mastectomy. Current guidelines recommend upfront sentinel lymph node biopsy during the index operation due to the potential of upstaging to invasive cancer. This study reviews a single institution’s experience with de-escalating axillary surgery using superparamagnetic iron oxide dye for axillary mapping in patients undergoing mastectomy for DCIS.

METHODS: This is a retrospective single-institution cross-sectional study. All medical records of patients who underwent mastectomy for a diagnosis of DCIS from August 2021 to January 2023 were reviewed and patients who had SPIO injected at the time of the index mastectomy were included in the study. Descriptive statistics of demographics, clinical information, pathology results, and interval sentinel lymph node biopsy were performed.

RESULTS: A total of 41 participants underwent 45 mastectomies for DCIS. The median age of the participants was 58 years (IQR = 17; range 25 to 76 years), and the majority of participants were female (97.8%). The most common indication for mastectomy was diffuse extent of disease (31.7%). On final pathology, 75.6% (34/45) of mastectomy specimens had DCIS without any type of invasion and 15.6% (7/45) had invasive cancer. Of the 7 cases with upgrade to invasive disease, 2 (28.6%) of them underwent interval sentinel lymph node biopsy. All sentinel lymph nodes biopsied were negative for cancer.

CONCLUSION: The use of superparamagnetic iron oxide dye can prevent unnecessary axillary surgery in patients with DCIS undergoing mastectomy.

PMID:38087058 | DOI:10.1007/s10549-023-07193-7

Int J Legal Med. 2023 Dec 13. doi: 10.1007/s00414-023-03143-6. Online ahead of print.

ABSTRACT

BACKGROUND: Forensic DNA phenotyping (FDP) consists of the use of methodologies for predicting externally visible characteristics (EVCs) from the genetic material of biological samples found in crime scenes and has proven to be a promising tool in aiding human identification in police activities. Currently, methods based on multiplex assays and statistical models of prediction of EVCs related to hair, skin, and iris pigmentation using panels of SNP and INDEL biomarkers have already been developed and validated by the forensic scientific community. As well as traces of pigmentation, an individual’s perceived age (PA) can also be considered an EVC and its estimation in unknown individuals can be useful for the progress of investigations. Liu and colleagues (2016) were pioneers in evidencing that, in addition to lifestyle and environmental factors, the presence of SNP and INDEL variants in the MC1R gene – which encodes a transmembrane receptor responsible for regulating melanin production – seems to contribute to an individual’s PA. The group highlighted the association between these MC1R gene polymorphisms and the PA in the European population, where carriers of risk haplotypes appeared to be up to 2 years older in comparison to their chronological age (CA).

PURPOSE: Understanding that genotype-phenotype relationships cannot be extrapolated between different population groups, this study aimed to test this hypothesis and verify the applicability of this variant panel in the Rio Grande do Sul admixed population.

METHODS: Based on genomic data from a sample of 261 volunteers representative of gaucho population and using a multiple linear regression (MLR) model, our group was able to verify a significant association among nine intronic variants in loci adjacent to MC1R (e.g., AFG3L1P, TUBB3, FANCA) and facial age appearance, whose PA was defined after age heteroclassification of standard frontal face images through 11 assessors.

RESULTS: Different from that observed in European populations, our results show that the presence of effect alleles (R) of the selected variants in our sample influenced both younger and older face phenotypes. The influence of each variant on PA is expressed as β values.

CONCLUSIONS: There are important molecular mechanisms behind the effects of MC1R locus on PA, and the genomic background of each population seems to be crucial to determine this influence.

PMID:38087053 | DOI:10.1007/s00414-023-03143-6