Nevin Manimala

Glob Pediatr Health. 2021 May 20;8:2333794X211018321. doi: 10.1177/2333794X211018321. eCollection 2021.

ABSTRACT

Background. Prelacteal feeding is defined as administration of any substances other than breast milk to newborn babies during the first 3 days after birth. Despite its negative health outcomes, it is commonly practiced in developing countries. Therefore, this study aimed at assessing the prevalence of pre-lacteal feeding practices and associated factors among mothers of children aged less than 2 years of age in Kersa district, Eastern Ethiopia. Method. A community-based cross-sectional study design was conducted among 465 mothers having children aged less than 2 years in Kersa district. A multistage sampling technique was used to select study participants. Binary logistic regression analysis was fitted to identify factors associated with prelacteal feeding practices. Variables with a P-value <.05 were identified as statistically significant factors. Results. The prevalence of pre-lacteal feeding in Kersa district was 46.4% (95% CI; 42.0%, 51.5%). Initiating breastfeeding after 1 hour of delivery (AOR = 10.80, 95% CI: (5.79, 20.17)), giving birth at home (AOR = 2.77, 95% CI: (1.41, 5.46)), not knowing risks associated with pre-lacteal feeding (AOR = 3.25, 95% CI: (1.72, 6.15)) and perceiving pre-lacteal feeding as beneficial (AOR = 9.56, 95% CI: (4.45, 20.52)) were factors significantly associated with practice pre-lacteal feeding practices. Conclusion. Significant proportions of mothers were practicing pre-lacteal feeding in the study area. Late initiation of breastfeeding, home delivery, not knowing risks of prelacteal feeding, and perceiving pre-lacteal feeding as beneficial were contributing factors for practicing of pre-lacteal feeding. Therefore, promoting institutional delivery and timely initiation of breastfeeding would reduce prelacteal feeding in Kersa district.

PMID:34095353 | PMC:PMC8142237 | DOI:10.1177/2333794X211018321

Open Forum Infect Dis. 2020 Dec 16;8(6):ofaa605. doi: 10.1093/ofid/ofaa605. eCollection 2021 Jun.

ABSTRACT

BACKGROUND: Patients who test positive for Clostridium difficile by polymerase chain reaction (PCR), with a negative toxin enzyme immunoassay (EIA), are commonly colonized and do not require treatment. However, clinicians often treat based on a positive PCR result regardless of the toxin EIA result. We evaluated the clinical impact of a microbiology reporting nudge, changing from a report that included both assay results along with treatment recommendations to one that suggested clinicians consider C difficile colonization or early infection.

METHODS: We conducted a retrospective cohort study of all adult patients admitted to a large multisite community hospital with a positive C difficile PCR result and negative toxin EIA from January 1, 2016 to June 30, 2018. We examined total days of therapy (DOT) and impacts on clinical outcomes.

RESULTS: One hundred ninety-nine episodes occurred preintervention and 165 episodes occurred postintervention. The mean DOTs per episode decreased from 13.6 to 7.9 days (difference -5.8 days; 95% confidence interval, -3.9 to -7.6) postintervention, with statistical process control charts suggesting special cause variation. Patients receiving no treatment increased from 6.5% to 23.6% postintervention (P < .0001). No significant changes in subsequent toxin positive disease (9.0% vs 6.7%), colectomy (0% vs 0.6%), mortality (7.5% vs 12.1%), or length of stay (18.5 vs 16 days) were observed.

CONCLUSIONS: Microbiology reporting nudges raising the possibility of C difficile colonization were associated with altered prescribing, reinforcing a postanalytic strategy for invoking change. Decreases in antimicrobial prescribing occurred without increasing subsequent disease or other adverse outcomes, suggesting a safe strategy for decreasing unnecessary treatment of C difficile colonization.

PMID:34095335 | PMC:PMC8176399 | DOI:10.1093/ofid/ofaa605

Biomed Res Int. 2021 May 22;2021:9919080. doi: 10.1155/2021/9919080. eCollection 2021.

ABSTRACT

Advanced single-cell profiling technologies promote exploration of cell heterogeneity, and clustering of single-cell RNA (scRNA-seq) data enables discovery of coexpression genes and network relationships between genes. In particular, single-cell profiling of circulating tumor cells (CTCs) can provide unique insights into tumor heterogeneity (including in triple-negative breast cancer (TNBC)), while scRNA-seq leads to better understanding of subclonal architecture and biological function. Despite numerous reports suggesting a direct correlation between circulating tumor cells (CTCs) and poor clinical outcomes, few studies have provided a thorough heterogeneity characterization of CTCs. In addition, TNBC is a disease with not only intertumor but also intratumor heterogeneity and represents various biological distinct subgroups that may have relationships with immune functions that are not clearly established yet. In this article, we introduce a new scheme for detecting genotypic characterization of single-cell heterogeneities and apply it to CTC and TNBC single-cell RNA-seq data. First, we use an existing mixture exponential family graph model to partition the cell-cell network; then, with the Markov random field model, we obtain more flexible network rewiring. Finally, we find the cell heterogeneity and network relationships according to different high coexpression gene modules in different cell subsets. Our results demonstrate that this scheme provides a reasonable and effective way to model different cell clusters and different biological enrichment gene clusters. Thus, using different internal coexpression genes of different cell clusters, we can infer the differences in tumor composition and diversity.

PMID:34095314 | PMC:PMC8164540 | DOI:10.1155/2021/9919080

Biomed Res Int. 2021 May 21;2021:6793860. doi: 10.1155/2021/6793860. eCollection 2021.

ABSTRACT

OBJECTIVE: Interleukin- (IL-) 34 is a new type of cytokine with neuroprotective effects discovered in recent years. However, the relationship between IL-34 and vascular dementia (VaD) has not yet been elucidated. The purpose of this study is to determine whether IL-34 is involved in cognitive impairment of VaD.

METHODS: From January 2017 to December 2020, 84 VaD patients and 60 healthy controls who attended Qingpu Branch of Zhongshan Hospital were prospectively included in the study. Once included in the study, demographic features of all research subjects are collected. They include age, gender, education, white blood cells (WBC), neutrophil, lymphocyte, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), triglycerides (TG), and total cholesterol (TC). Meanwhile, the Montreal Cognitive Assessment (MoCA) scale was used to assess the cognitive function of participants. The serum IL-34 level was determined by enzyme-linked immunosorbent assay (ELISA).

RESULTS: There was no significant difference between the demographic features of VaD patients and healthy controls (p > 0.05). However, the serum IL-34 levels of VaD patients and healthy controls are 27.6 ± 3.9 pg/ml and 41.8 ± 6.0 pg/ml, respectively, and there is a significant statistical difference between them (p < 0.001). The results of bivariate correlation analysis showed that serum IL-34 levels were significantly positively correlated with MoCA scores (r = 0.371, p = 0.023). Further regression analysis showed that IL-34 was still correlated with MoCA after adjusting for demographic features (β = 0.276, p = 0038).

CONCLUSIONS: Serum IL-34 levels in VaD patients were significantly reduced, which may be an independent predictor of cognitive impairment in VaD patients.

PMID:34095310 | PMC:PMC8163526 | DOI:10.1155/2021/6793860

Biomed Res Int. 2021 May 21;2021:5544188. doi: 10.1155/2021/5544188. eCollection 2021.

ABSTRACT

The aim of the present work was to investigate the risk factors for gastric cancer- (GC-) associated thrombotic diseases in a Han Chinese population. A total of 333 patients diagnosed with GC, 68 with thrombotic diseases included in the case group and the remaining 265 in the control group, were enrolled. The relevant data for the participants, including general information (gender, age, smoking, and drinking), comorbidities (diabetes, hypertension, and anemia), tumor-related data (tumor site, histology, degree of differentiation, and clinical stage), and treatment-related data (surgery, chemotherapy, hormones, transfusion, and peripherally inserted central venous catheter (PICC)), were collected. Statistically significant factors derived from univariate analyses were then subjected to multivariate logistic regression analyses. The results demonstrate a statistically significant difference in age, diabetes, hypertension, histology, surgery, chemotherapy, and PICC (P < 0.05), compared with control. Age, diabetes, surgery, and PICC serve as independent risk factors for GC-associated thrombotic diseases (P < 0.05). The present work demonstrates that GC-associated thrombotic diseases are significantly associated with age, diabetes, surgery, and PICC, suggesting a potential target for early detection and preventive strategy for GC patients with thrombophilia.

PMID:34095299 | PMC:PMC8164527 | DOI:10.1155/2021/5544188

Front Cardiovasc Med. 2021 May 19;8:683932. doi: 10.3389/fcvm.2021.683932. eCollection 2021.

ABSTRACT

Background: Diabetes mellitus (DM) has a high morbidity and mortality worldwide, and it is a risk factor for cardiovascular diseases. Non-diabetic stress hyperglycemia is common in severely ill patients, and it could affect prognosis. This study aimed to analyze the influence of different blood glucose levels on prognosis from the perspective of stress hyperglycemia by comparing them with normal blood glucose levels and those of patients with DM. Methods: A retrospective study of 1,401 patients in coronary care unit (CCU) from the critical care database called Medical Information Mart for Intensive Care IV was performed. Patients were assigned to the following groups 1-4 based on their history of DM, random blood glucose, and HbA1c levels: normal blood glucose group, moderate stress hyperglycemia group, severe stress hyperglycemia group and DM group. The main outcome of this study was 30- and 90-day mortality rates. The associations between groups and outcomes were analyzed using Kaplan-Meier survival analysis, Cox proportional hazard regression model and competing risk regression model. Results: A total of 1,401 patients in CCU were enrolled in this study. The Kaplan-Meier survival curve showed that group 1 had a higher survival probability than groups 3 and 4 in terms of 30- and 90-day mortalities. After controlling the potential confounders in Cox regression, groups 3 and 4 had a statistically significant higher risk of both mortalities than group 1, while no difference in mortality risk was found between groups 2 and 1. The hazard ratios [95% confidence interval (CI)] of 30- and 90-day mortality rates for group 3 were 2.77(1.39,5.54) and 2.59(1.31,5.12), respectively, while those for group 4 were 1.92(1.08,3.40) and 1.94(1.11,3.37), respectively. Conclusions: Severe stress hyperglycemia (≥200 mg/dL) in patients without DM in CCU may increase the risk of short-term death, which is greater than the prognostic effect in patients with diabetes. Patients with normal blood glucose levels and moderate stress hyperglycemia (140 mg/dL ≤ RBG <200 mg/dL) had no effect on short-term outcomes in patients with CCU.

PMID:34095265 | PMC:PMC8169960 | DOI:10.3389/fcvm.2021.683932

Front Cardiovasc Med. 2021 May 20;8:616081. doi: 10.3389/fcvm.2021.616081. eCollection 2021.

ABSTRACT

Background: Acute coronary syndrome (ACS) is the main cause of death and morbidity worldwide. The present study aims to investigate the altered metabolites in plasma from patients with ACS and sought to identify metabolic biomarkers for ACS. Methods: The plasma metabolomics profiles of 284 ACS patients and 130 controls were carried out based on an untargeted liquid chromatography coupled with tandem mass spectrometry (LC-MS) approach. Multivariate statistical methods, pathway enrichment analysis, and univariate receiver operating characteristic (ROC) curve analysis were performed. Results: A total of 328 and 194 features were determined in positive and negative electrospray ionization mode in the LC-MS analysis, respectively. Twenty-eight metabolites were found to be differentially expressed, in ACS patients relative to controls (p < 0.05). Pathway analysis revealed that these metabolites are mainly involved in synthesis and degradation of ketone bodies, phenylalanine metabolism, and arginine and proline metabolism. Furthermore, a diagnostic model was constructed based on the metabolites identified and the areas under the curve (AUC) for 5-oxo-D-proline, creatinine, phosphatidylethanolamine lyso 16:0, and LPC (20:4) range from 0.764 to 0.844. The higher AUC value of 0.905 was obtained for the combined detection of phosphatidylethanolamine lyso 16:0 and LPC (20:4). Conclusions: Differential metabolic profiles may be useful for the effective diagnosis of ACS and may provide additional insight into the molecular mechanisms underlying ACS.

PMID:34095243 | PMC:PMC8172787 | DOI:10.3389/fcvm.2021.616081

Front Mol Biosci. 2021 May 21;8:658269. doi: 10.3389/fmolb.2021.658269. eCollection 2021.

ABSTRACT

Random tomography is a common problem in imaging science and refers to the task of reconstructing a three-dimensional volume from two-dimensional projection images acquired in unknown random directions. We present a Bayesian approach to random tomography. At the center of our approach is a meshless representation of the unknown volume as a mixture of spherical Gaussians. Each Gaussian can be interpreted as a particle such that the unknown volume is represented by a particle cloud. The particle representation allows us to speed up the computation of projection images and to represent a large variety of structures accurately and efficiently. We develop Markov chain Monte Carlo algorithms to infer the particle positions as well as the unknown orientations. Posterior sampling is challenging due to the high dimensionality and multimodality of the posterior distribution. We tackle these challenges by using Hamiltonian Monte Carlo and a global rotational sampling strategy. We test the approach on various simulated and real datasets.

PMID:34095220 | PMC:PMC8177743 | DOI:10.3389/fmolb.2021.658269

Turk J Med Sci. 2021 Jun 7. doi: 10.3906/sag-2103-52. Online ahead of print.

ABSTRACT

BACKGROUND/AIM: We aimed to investigate the associations between the radiographic phenotypes and the presence of metabolic syndrome (MetS) in patients with knee osteoarthritis (OA).

MATERIALS AND METHODS: We evaluated women age 40 and over who presented to our outpatient clinics with knee pain and fulfilled the clinical and radiographic criteria for the classification of idiopathic OA of the knee. Patients were categorized into two groups concerning dominant radiographic phenotype. We included consecutive 50 patients in each group. All patients were evaluated in terms of MetS according to the revised diagnostic criteria of the International National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) and the World Health Organization (WHO).

RESULTS: Overall MetS prevalence was found to be 79% according to the NCEP ATP III-MetS criteria and 65% according to the WHO-MetS criteria. Prevalence of MetS was higher in the joint space narrowing (JSN)-Dominant group compared to the osteophyte (O)-Dominant knee OA group, but the difference did not reach statistical significance. However, in subgroup analysis (54 patients), in which we excluded patients with a past medical history of type 2 diabetes mellitus (DM), the prevalence of NCEP ATP III-MetS was statistically significantly higher in the JSN-Dominant group compared to the O-Dominant group [22 (75.9%) vs 12 (48%) respectively, p = 0.03]. Logistic regression analysis in the subgroup demonstrated that the presence of NCEP ATP III-MetS was an independent risk factor for JSN-Dominant knee OA phenotype [OR and 95% CI = 3.48 (1.09 – 11.13)].

CONCLUSION: The prevalence of MetS is quite high in patients with knee OA and is particularly pronounced in patients with JSN-Dominant radiographic phenotype. Moreover, our results suggest that MetS is an independent risk factor for JSN-Dominant knee OA in patients with no past medical history of DM.

PMID:34092051 | DOI:10.3906/sag-2103-52

Liver Transpl. 2021 Jun 5. doi: 10.1002/lt.26195. Online ahead of print.

ABSTRACT

BACKGROUND: Organ allocation in liver transplantation (LT) remains imperfect. Periodic centre reviews ensure programs transparently evaluate the impact of practice on access to transplantation, reflecting in particular patient (primary disease, social) and program (deceased vs live donation) factors.

METHODS: Adult Ontario residents listed for first liver transplantation at Toronto General Hospital from November 2012 to May 2019 were reviewed. Analyses were performed between distance-to-transplant-centre, income, education level, population density and primary liver disease with LT, deceased donor liver transplant (DDLT), living donor liver transplant (LDLT), and delisting.

RESULTS: Of 1735 listed patients, n=549 were delisted (32%), while n=1071 were transplanted (62%), with 819 DDLT recipients (77%) and 252 LDLT recipients (24%). On univariate analysis, DDLT recipients lived 30% closer (median 39.7 vs. 60.6 km, p<0.001), lived in more populous areas (median 8501.0 vs. 6868.5 people in 1 km radius, p<0.001), and resided in households that earned 10% less (median $92,643.17 vs. $102,820.89 Canadian dollars, p<0.001) compared to LDLT recipients. These findings with population density and income differences between DDLT vs. LDLT receival remained significant on multivariate modelling even when accounting for primary liver disease. Primary liver disease was a statistically significant factor on multivariate analyses in LT receival (p=0.001) as well as DDLT vs. LDLT receival (p<0.001). Of patients listed for end-stage liver disease, more patients with autoimmune cholestatic liver diseases received LDLT (34-41%) than DDLT (27-30%); this contrasted patients with non-cholestatic diseases LDLT (8-19%) vs. DDLT (37-59%) receival (p<0.001).

CONCLUSION: Review of transplant allocation in a large mixed-donor North American liver transplant program demonstrates how patient social determinants and primary disease etiology continue to significantly associate with ultimate transplantation.

PMID:34092028 | DOI:10.1002/lt.26195