Nevin Manimala

Acta Paediatr. 2024 Mar 22. doi: 10.1111/apa.17207. Online ahead of print.

ABSTRACT

AIM: This study aimed to address the critical need for more accurate growth reference charts for preterm infants, with a particular focus on low- and very low-birth-weight infants.

METHODS: The subjects were recruited at a single tertiary centre. The cohort comprised singleton and twin infants born before 37 weeks of gestation, with data collected from 2000 to 2016. Standardised measurements of body parameters were recorded in this mixed longitudinal survey. LMS method was utilised for data analysis. Statistical analysis was performed using SPSS Statistics Version 21. The validation with another new cohort was executed.

RESULTS: A total of 1781 infants (52.5% boys) met the inclusion criteria. The median gestational age at birth was 30 weeks, with a median birth weight of 1350 grams. The main findings included the construction of ImaGrow charts for low- and very low-birth-weight infants and significant differences in growth trajectories compared to Fenton+WHO charts.

CONCLUSION: Our comprehensive growth references, ImaGrow, are based on a long-term auxological assessment of preterm infants and differ from charts derived from size-at-birth standards or charts for term babies. These charts have significant implications for clinical practice in monitoring and assessing the growth of preterm infants.

PMID:38516724 | DOI:10.1111/apa.17207

Luminescence. 2024 Mar;39(3):e4728. doi: 10.1002/bio.4728.

ABSTRACT

A novel spectrofluorimetric method has been developed for determination of antazoline (ANT) and tetryzoline (TET) in their pharmaceutical formulation. A combined application of synchronous spectrofluorimetry and second derivative mathematical treatment was developed. The proposed method depends on reacting the cited drugs with dansyl chloride (DNS-Cl) being a suitable derivatizing agent generating highly fluorescent derivatives measured at emission wavelengths of 703.0 and 642.0 nm after excitation wavelengths of 350.0 and 320.0 nm for ANT and TET, respectively. The joint use of synchronous spectrofluorimetry with second derivative mathematical treatment is for the first time to be developed and optimized in aid of using fluorescence data manager software generating second derivative peak amplitudes at 556.5 nm for ANT and 516.7 nm for TET. Linear responses have been represented over a wide range of concentration (0.5-12.0 μg/mL for ANT and 0.5-10.0 μg/mL for TET). Additionally, statistical comparison of the developed method with the official ones has been carried out where no significant difference was found. Additionally, greenness profile assessment was accomplished by means of four metric tools. Indeed, the method developed is found to be precise, sensitive, and discriminating to assess the cited drugs for regular analysis.

PMID:38516711 | DOI:10.1002/bio.4728

Med Educ Online. 2024 Dec 31;29(1):2331852. doi: 10.1080/10872981.2024.2331852. Epub 2024 Mar 22.

ABSTRACT

BACKGROUND: Simulated cases are widely used in medical education to develop clinical reasoning skills and discuss key topics around patient care. Such cases present an opportunity to demonstrate real world encounters with diverse patient and health provider identities, impacts of social and structural determinants of health, and demonstrate a generalist approach to problems. However, despite many calls-to-action for medical schools to better incorporate equity, diversity and inclusion (EDI) and generalism, it remains difficult to evaluate how well these goals are being met.

METHODS: A quality improvement project was completed at a single medical school to evaluate the domains of generalism and EDI within simulated cases used in the preclinical curriculum. Generalism was evaluated using the Toronto Generalism Assessment Tool (T-GAT). EDI was evaluated using a locally developed novel tool. Analysis included descriptive statistics and Pearson correlation coefficient.

RESULTS: A total of 49 simulated cases were reviewed. Twelve generalism and 5 EDI items were scored on a 5-point Likert scale, with higher scores indicating better demonstration of generalism or EDI within a case. Average generalism score across all cases was 45.6/60. Average EDI score across all cases was 11.7/25. Only 21/49 cases included representation of one or more diverse identity categories. The most common diverse identity represented was non-white races/ethnicities, and the identity represented the least was diversity in language fluency. Generalism and EDI scores demonstrated a weak positive correlation (R² = 0.25).

CONCLUSIONS: Quantitative evaluation of simulated cases using specific generalism and EDI scoring tools was successful in generating insight into areas of improvement for teaching cases. This approach identified key content areas for case improvement and identities that are currently underrepresented in teaching cases. Similar approaches could be feasibly used by other medical schools to improve generalism and EDI in teaching cases or other curricular materials.

PMID:38516698 | DOI:10.1080/10872981.2024.2331852

Oncol Lett. 2024 Mar 7;27(5):196. doi: 10.3892/ol.2024.14329. eCollection 2024 May.

ABSTRACT

Ovarian high-grade serous carcinoma (OHGSC) is the most common type of ovarian cancer worldwide. Genome sequencing has identified mutations in chromatin remodeling factors (CRFs) in gynecological cancer, such as clear cell carcinoma, endometrioid carcinoma and endometrial serous carcinoma. However, to the best of our knowledge, the association between CRFs and OHGSC remains unexplored. The present study aimed to investigate the clinicopathological and molecular characteristics of CRF dysfunction in OHGSC. CRF alterations were analyzed through numerous methods, including the analysis of public next-generation sequencing (NGS) data from 585 ovarian serous carcinoma cases from The Cancer Genome Atlas (TCGA), immunohistochemistry (IHC), and DNA copy number assays, which were performed on 203 surgically resected OHGSC samples. In the public NGS dataset, the most frequent genetic alteration was actin-like protein 6A (ACTL6A) amplification at 19.5%. Switch/sucrose non-fermentable related, matrix associated, actin dependent regulator of chromatin subfamily c member 2 (SMARCC2) amplification (3.1%) was associated with significantly decreased overall survival (OS). In addition, chromodomain-helicase-DNA-binding protein 4 (CHD4) amplification (5.7%) exhibited unfavorable outcome trends, although not statistically significant. IHC revealed the protein expression loss of ARID1A (2.5%), SMARCA2 (2.5%) and SMARCA4 (3.9%). The protein expression levels of ACTL6A, SMARCC2 and CHD4 were evaluated using H-score. Patients with low protein expression levels of ACTL6A showed a significantly decreased OS. Copy number gain or gene amplification was demonstrated in ACTL6A (66.2%) and SMARCC2 (33.5%), while shallow deletion or deep deletion was demonstrated in CHD4 (70.7%). However, there was no statistically significant difference in protein levels of these CRFs, between the different copy number alterations (CNAs). Overall, OHGSC exhibited CNAs and protein loss, indicating possible gene alterations in CRFs. Moreover, there was a significant association between the protein expression levels of ACTL6A and poor prognosis. Based on these findings, it is suggested that CRFs could serve as prognostic markers for OHGSC.

PMID:38516682 | PMC:PMC10955683 | DOI:10.3892/ol.2024.14329

Front Plant Sci. 2024 Mar 7;15:1308553. doi: 10.3389/fpls.2024.1308553. eCollection 2024.

ABSTRACT

Lettuce (Lactuca sativa) germination is sensitive to environmental conditions. Recently, hydrogel has received increased attention as an alternative media to soil for seed germination. Compared to soil seeding, hydrogel-aided germination provides more controlled seeding environments. However, there are still challenges preventing hydrogel-aided seed germination from being widely used in industry production or academic studies, such as hydrogel formulation variations, seeding operation standardization, and germination evaluation. In this study, we tested how the combination of multiple environmental conditions affect lettuce seed germination time, which is measured as the time needed for the first pair of leaves to appear (leaf emergence) or, alternatively, the third leaf to appear (leaf development). We found that germination time and success rate of two lettuce varieties (Iceberg A and Butter Crunch) showed different sensitivities to pH, Hoagland formulations and concentrations, light intensity, and hydrogel content. We have conducted statistical analysis on the correlation between germination time and these environmental conditions.

PMID:38516663 | PMC:PMC10955070 | DOI:10.3389/fpls.2024.1308553

SAGE Open Med. 2024 Mar 20;12:20503121241238148. doi: 10.1177/20503121241238148. eCollection 2024.

ABSTRACT

OBJECTIVES: To determine the optimal initial insulin dosage for controlling hyperglycemia in COVID-19 patients receiving steroids, an area with limited data.

METHODS: We retrospectively analyzed 156 COVID-19 patients with steroid-induced hyperglycemia treated with insulin. Patients were categorized by their total daily dose of subcutaneous insulin therapy when starting dexamethasone ⩾6 mg/day or equivalent dose of glucocorticoid: Group A (⩽0.29 units/kg), Group B (0.3-0.49 units/kg), Group C (0.5-0.69 units/kg), and Group B (⩾0.7 units/kg). Treatment failure was defined as mean blood glucose level > 280 mg/dL for two consecutive days after initiating insulin or any blood glucose ⩾ 400 mg/dL.

RESULTS: The mean age was 64 ± 14 years, with 50% male, and a mean body mass index of 26.9 ± 6.9 kg/m². Most had preexisting type 2 diabetes (62%). Mean admission blood glucose and HbA1c were 233 ± 112 mg/dL and 7.8 ± 2.3%, respectively. Group A had the lowest HbA1c (6.7 ± 1.2%), while group D had the highest (9.8 ± 2.5%). Median daily dexamethasone dosage or equivalent was 36 (IQR 16.72) mg, with no significant differences in among groups. Group A had the lowest treatment failure rate. There were no significant differences in treatment failure rate between Groups B, C, and D. Additionally, there were no statistically significant differences in mean BG across the groups: Group A 232 ± 42 mg/dL, Group B 247 ± 57 mg/dL, Group C 247 ± 61 mg/dL, and Group D 227 ± 67 mg/dL (p = 0.2). Group D had a significantly higher rate of level 1 hypoglycemia (p = 0.008), while no differences in clinically significant hypoglycemia (level 2 or 3) were observed between groups.

CONCLUSIONS: Among patients requiring TDD ⩾ 0.3 units/kg/day, there was no significant difference in treatment failure rate between Groups B, C, and D. Group D had the highest rate of level 1 hypoglycemia. This initial insulin dosage for hospitalized COVID-19 patients on high-dose steroid therapy should be personalized.

PMID:38516643 | PMC:PMC10956164 | DOI:10.1177/20503121241238148

SAGE Open Med. 2024 Mar 21;12:20503121241237115. doi: 10.1177/20503121241237115. eCollection 2024.

ABSTRACT

INTRODUCTION: Immunization helps reduce morbidity and mortality attributable to severe vaccine-preventable childhood illnesses. However, vaccination coverage and the quality of immunization data remain challenging in Ethiopia. This has led to poor planning, suboptimal vaccination coverage, and the resurgence of vaccine-preventable disease outbreaks in under-immunized pocket areas. The problem is further compounded by the occurrence of the COVID-19 pandemic and the disruption of the health information system due to recurrent conflict. This study assessed the current status of the immunization service and its challenges in Ethiopia.

METHODS: A mixed-methods study was conducted in three regions of Ethiopia from 21 to 31 May, 2023. A survey of administrative reports was done in a total of 69 health facilities in 14 woredas (districts). Nine KIIs were conducted at a district level among immunization coordinators selected from three regions to explore the challenges of the immunization program. Linear regression and descriptive statistics were used to analyze the quantitative data. Thematic analysis was applied to analyze the qualitative data. The findings from the qualitative data were triangulated to supplement the quantitative results.

RESULT: Two-thirds (66.4%) of the children were fully vaccinated, having received all vaccines, including the first dose of the MCV1, by 12 months of age, as reported through administrative reports collected from health facility records. Catchment area population size and region were significantly associated with the number of fully immunized children (p < 0.001 and p = 0.005, respectively). The vaccination dropout rates of the first to third dose of pentavalent vaccine and the first dose of pentavalent vaccine to the first dose of MCV1 were 8.6% and 7.4%, respectively. A considerable proportion of health facilities lack accurate data to calculate vaccination coverage, while most of them lack accurate data for dropout rates. Longer waiting time, interruptions in vaccine supply or shortage, inaccessibility of health facilities, internal conflict and displacement, power interruption and refrigerator breakdown, poor counseling practice, and caretakers’ lack of awareness, fear of side effects, and forgetfulness were the reasons for the dropout rate and low coverage. The result also showed that internal conflict and displacement have significantly affected immunization coverage, with the worst effects seen on the most marginalized populations.

CONCLUSION: The study revealed low vaccination coverage, a high dropout rate, and poor quality of immunization data. Access and vaccination coverage among marginalized community groups (e.g., orphans and street children) were also low. Hence, interventions to address organizational, behavioral, technical, and contextual (conflict and the resulting internal displacement) bottlenecks affecting the immunization program should be addressed.

PMID:38516641 | PMC:PMC10956145 | DOI:10.1177/20503121241237115

Optim Lett. 2023 Jun;17(5):1133-1159. doi: 10.1007/s11590-022-01919-0. Epub 2022 Sep 4.

ABSTRACT

The task of projecting onto ℓp norm balls is ubiquitous in statistics and machine learning, yet the availability of actionable algorithms for doing so is largely limited to the special cases of p∈{0, 1, 2, ∞}. In this paper, we introduce novel, scalable methods for projecting onto the ℓp-ball for general p>0. For p≥1, we solve the univariate Lagrangian dual via a dual Newton method. We then carefully design a bisection approach For p<1, presenting theoretical and empirical evidence of zero or a small duality gap in the non-convex case. The success of our contributions is thoroughly assessed empirically, and applied to large-scale regularized multi-task learning and compressed sensing. The code implementing our methods is publicly available on Github.

PMID:38516636 | PMC:PMC10956251 | DOI:10.1007/s11590-022-01919-0

Biol Imaging. 2023 Dec 14;4:e1. doi: 10.1017/S2633903X23000260. eCollection 2024.

ABSTRACT

Image analysis techniques provide objective and reproducible statistics for interpreting microscopy data. At higher dimensions, three-dimensional (3D) volumetric and spatiotemporal data highlight additional properties and behaviors beyond the static 2D focal plane. However, increased dimensionality carries increased complexity, and existing techniques for general segmentation of 3D data are either primitive, or highly specialized to specific biological structures. Borrowing from the principles of 2D topological data analysis (TDA), we formulate a 3D segmentation algorithm that implements persistent homology to identify variations in image intensity. From this, we derive two separate variants applicable to spatial and spatiotemporal data, respectively. We demonstrate that this analysis yields both sensitive and specific results on simulated data and can distinguish prominent biological structures in fluorescence microscopy images, regardless of their shape. Furthermore, we highlight the efficacy of temporal TDA in tracking cell lineage and the frequency of cell and organelle replication.

PMID:38516632 | PMC:PMC10951800 | DOI:10.1017/S2633903X23000260

Biol Imaging. 2024 Feb 15;4:e2. doi: 10.1017/S2633903X24000011. eCollection 2024.

ABSTRACT

Imaging platforms for generating highly multiplexed histological images are being continually developed and improved. Significant improvements have also been made in the accuracy of methods for automated cell segmentation and classification. However, less attention has focused on the quantification and analysis of the resulting point clouds, which describe the spatial coordinates of individual cells. We focus here on a particular spatial statistical method, the cross-pair correlation function (cross-PCF), which can identify positive and negative spatial correlation between cells across a range of length scales. However, limitations of the cross-PCF hinder its widespread application to multiplexed histology. For example, it can only consider relations between pairs of cells, and cells must be classified using discrete categorical labels (rather than labeling continuous labels such as stain intensity). In this paper, we present three extensions to the cross-PCF which address these limitations and permit more detailed analysis of multiplex images: topographical correlation maps can visualize local clustering and exclusion between cells; neighbourhood correlation functions can identify colocalization of two or more cell types; and weighted-PCFs describe spatial correlation between points with continuous (rather than discrete) labels. We apply the extended PCFs to synthetic and biological datasets in order to demonstrate the insight that they can generate.

PMID:38516631 | PMC:PMC10951806 | DOI:10.1017/S2633903X24000011