Nevin Manimala

Ther Apher Dial. 2024 May 1. doi: 10.1111/1744-9987.14136. Online ahead of print.

ABSTRACT

INTRODUCTION: Hemodialysis (HD) patients have become a serious public health problem, the number of which is increasing every year worldwide. This study aimed to determine the relationship between satisfaction with life, dietary attitude, and comfort level in patients receiving HD treatment.

METHODS: This research was conducted in a relational cross-sectional descriptive design. The research was conducted with 174 patients (85% of the population) receiving HD treatment between March 20 and September 30, 2023. In the study, hierarchical regression analysis was performed with SPSS 25.0. Machine learning analysis and prediction were performed using R programming language, version 4.1.3.

RESULTS: The model used to determine the factors affecting satisfaction with life was significant and usable (F(2,171) = 25.855, p = 0.001). Attitudes of HD patients toward dietary therapy and their HD comfort levels together explained 22.3% of the total variance of satisfaction with life. In the regression model, according to the results of the t-test regarding the significance of the regression coefficient, the increase in the HD comfort levels of the participants (t = 2.668, p = 0.008) and the increase in the attitude of the HD patients toward dietary therapy (t = 5.897, p = 0.001) caused a statistical increase in “satisfaction with life.” According to Shapley values, the most important variable in the prediction of satisfaction with life variable is attitude for the dietary attitude.

CONCLUSION: It was determined that the increase in the comfort levels of HD patients and their positive dietary attitudes increased satisfaction with life. It is recommended to provide education to increase patients’ diet attitudes and comfort levels.

PMID:38690662 | DOI:10.1111/1744-9987.14136

Hypertension. 2024 May 1. doi: 10.1161/HYPERTENSIONAHA.123.22250. Online ahead of print.

ABSTRACT

BACKGROUND: Senescence, a mechanism of cellular aging, which is characterized by irreversible proliferation arrest and a proinflammatory secretory phenotype, has been documented in women with preeclampsia. As cellular senescence can persist and progress, we postulated that it is associated with accelerated aging phenotype and accumulation of comorbidities in women with a history of preeclampsia.

METHODS: We included a cohort of women with a history of preeclampsia (n=40) age- and parity-matched to a group of referent women with normotensive pregnancies (n=40). Women with prior major cardiovascular events, neurological, or autoimmune conditions were excluded. We collected urine and blood samples to study markers of aging, data on multimorbidity at the time of enrollment, and prospectively followed them for events over the course of 6 years, on average.

RESULTS: Women with a history of preeclampsia exhibited unfavorable aging profiles compared with referent women, including decreased urinary α-Klotho (P=0.018); increased leptin (P=0.016) and leptin/adiponectin ratio (P=0.027), and increased extracellular vesicles positive for tissue factor (P=0.025). Women with a history of preeclampsia likewise had a higher rate of comorbidities at the time of enrollment (P=0.003) and had a 4× higher risk of developing major cardiovascular events compared with referent women (P=0.003).

CONCLUSIONS: Our data suggest that a history of preeclampsia is associated with accelerated aging as indicated by senescence marker differences and the accumulation of multimorbidity later in life. Targeting cellular senescence may offer novel, mechanism-based approaches for the diagnosis and treatment of adverse health outcomes in women with a history of preeclampsia.

PMID:38690656 | DOI:10.1161/HYPERTENSIONAHA.123.22250

Int J Numer Method Biomed Eng. 2024 May 1:e3831. doi: 10.1002/cnm.3831. Online ahead of print.

ABSTRACT

Despite being among the most common medical procedures, needle insertions suffer from a high error rate. Impedance measurements using electrode-equipped needles offer promise for improved tissue targeting and reduced errors. Impedance visualization usually requires an extensive pre-measured impedance dataset for tissue differentiation and knowledge of the electric fields contributing to the resulting impedances. This work presents two finite element simulation approaches for both problems. The first approach describes the generation of a multitude of impedances with Monte Carlo simulations for both, homogeneous and inhomogeneous tissue to circumvent the need to rely on previously measured data. These datasets could be used for tissue discrimination. The second method describes the simulation of the spatial sensitivity distribution of an electrode layout. Two singularity analysis methods were employed to determine the bulk of the sensitivity within a finite volume, which in turn enables consistent 3D visualization. The modeled electrode layout consists of 12 electrodes radially placed around a hypodermic needle. Electrical excitation was simulated using two neighboring electrodes for current carriage and voltage pickup, which resulted in 12 distinct bipolar excitation states. Both, the impedance simulations and the respective singularity analysis methods were compared with each other. The results show that the statistical spread of impedances is highly dependent on the tissue type and its inhomogeneities. The bounded bulk of sensitivities of both methods are of similar extent and symmetry. Future models should incorporate more detailed tissue properties such as anisotropy or changing material properties due to tissue deformation to gain more accurate predictions.

PMID:38690649 | DOI:10.1002/cnm.3831

Stat Med. 2024 May 1. doi: 10.1002/sim.10096. Online ahead of print.

ABSTRACT

This article presents a novel method for learning time-varying dynamic Bayesian networks. The proposed method breaks down the dynamic Bayesian network learning problem into a sequence of regression inference problems and tackles each problem using the Markov neighborhood regression technique. Notably, the method demonstrates scalability concerning data dimensionality, accommodates time-varying network structure, and naturally handles multi-subject data. The proposed method exhibits consistency and offers superior performance compared to existing methods in terms of estimation accuracy and computational efficiency, as supported by extensive numerical experiments. To showcase its effectiveness, we apply the proposed method to an fMRI study investigating the effective connectivity among various regions of interest (ROIs) during an emotion-processing task. Our findings reveal the pivotal role of the subcortical-cerebellum in emotion processing.

PMID:38690642 | DOI:10.1002/sim.10096

Chem Biodivers. 2024 May 1:e202400862. doi: 10.1002/cbdv.202400862. Online ahead of print.

ABSTRACT

The chemical composition of 33 oil samples isolated from the berries of individual trees of two subspecies of Juniperus oxycedrus L., collected in four locations in Tlemcen and Aïn Temouchent provinces, was investigated by GC-FID, GC/MS and 13CNMR. In total, 83 compounds were identified, accounting for 85.9% to 98.6% of the total composition. Yields ranged between 0.02 and 0.40% (w/w). All compositions were submitted to statistical analysis. Combination of hierarchical clustering dendrogram and principal component analysis suggested the existence of two groups, the second group being sub-divided into two sub-groups. Groups and sub-groups were distinguished with respect to their contents of α-pinene, germacrene D, myrcene and, to a lesser extent, of manoyl oxide. The chemical composition of the oils belonging to subsp. oxycedrus was largely dominated by monoterpenes. α-Pinene (23.7 – 63.2%) and germacrene D (4.5 – 25.4%) were the major components, followed by myrcene (3.1 – 16.7%). Conversely, samples oils of subsp. macrocarpa were largely dominated by germacrene D (4.4 – 30.0%), followed by a lower content of α-pinene (10.0 – 24.3%) and myrcene (1.0 – 4.3%) and a significant content of manoyl oxide (4.3 – 9.9%).

PMID:38690641 | DOI:10.1002/cbdv.202400862

Cephalalgia. 2024 May;44(5):3331024241251488. doi: 10.1177/03331024241251488.

ABSTRACT

BACKGROUND: We aimed to develop the first machine learning models to predict citation counts and the translational impact, defined as inclusion in guidelines or policy documents, of headache research, and assess which factors are most predictive.

METHODS: Bibliometric data and the titles, abstracts, and keywords from 8600 publications in three headache-oriented journals from their inception to 31 December 2017 were used. A series of machine learning models were implemented to predict three classes of 5-year citation count intervals (0-5, 6-14 and, >14 citations); and the translational impact of a publication. Models were evaluated out-of-sample with area under the receiver operating characteristics curve (AUC).

RESULTS: The top performing gradient boosting model predicted correct citation count class with an out-of-sample AUC of 0.81. Bibliometric data such as page count, number of references, first and last author citation counts and h-index were among the most important predictors. Prediction of translational impact worked optimally when including both bibliometric data and information from the title, abstract and keywords, reaching an out-of-sample AUC of 0.71 for the top performing random forest model.

CONCLUSION: Citation counts are best predicted by bibliometric data, while models incorporating both bibliometric data and publication content identifies the translational impact of headache research.

PMID:38690640 | DOI:10.1177/03331024241251488

J Exp Biol. 2024 May 1:jeb.247104. doi: 10.1242/jeb.247104. Online ahead of print.

ABSTRACT

Desert ants stand out as some of the most intriguing insect navigators, having captured the attention of scientists for decades. This includes the structure of walking trajectories during goal approach and search behaviour for the nest and familiar feeding sites. We analyse such trajectories with regard to changes in walking direction. The directional change of the ants is quantified, i.e. an angle θ between trajectory increments of a given arclength λ is computed. This was done for different length scales λ, according to our goal of analysing desert ant path characteristics with respect to length scale. (i) Varying λ through more than two orders of magnitude demonstrated Brownian motion characteristics typical of the random walk component of search behaviour. Unexpectedly, this random walk component was also present in – supposedly rather linear – approach trajectories. (ii) There were small but notable deviations from a uniform angle distribution that is characteristic of random walks. This was true for specific search situations, mostly close to the (virtual) goal position. (iii) Experience with a feeder position resulted in straighter approaches and more focussed searches, which was also true for nest searches, albeit to lesser extents. Taken together, these results both verify and extend previous studies on desert ant path characteristics. Of particular interest are the ubiquitous Brownian motion signatures and specific deviations thereof close to the goal position, indicative of unexpectedly structured search behaviour.

PMID:38690630 | DOI:10.1242/jeb.247104

Br J Clin Pharmacol. 2024 May 1. doi: 10.1111/bcp.16082. Online ahead of print.

ABSTRACT

AIMS: Corticosteroids are the treatment of choice for many inflammatory diseases but often lead to adverse effects, including hyperglycaemia. This study investigated the mechanisms driving differential effects on glucose control for AZD9567, an oral nonsteroidal selective glucocorticoid receptor modulator vs. prednisolone in 46 patients with type 2 diabetes mellitus.

METHODS: In this randomized, double-blind, 2-way cross-over study (NCT04556760), participants received either AZD9567 72 mg and prednisolone 40 mg daily (cohort 1); AZD9567 40 mg and prednisolone 20 mg daily (cohort 2); or placebo and prednisolone 5 mg daily (cohort 3). Treatment duration was 3 days with a 3-week washout between treatment periods. Glycaemic control was assessed after a standardized meal and with continuous glucose monitoring.

RESULTS: A significant difference between AZD9567 and prednisolone in favour of AZD9567 was observed for the change from baseline to Day 4 glucose excursions postmeal in cohort 1 (glucose area under the curve from 0 to 4 h -4.54%; 95% confidence interval [CI]: -8.88, -0.01; P = .049), but not in cohort 2 (-5.77%; 95% CI: -20.92, 12.29; P = .435). In cohort 1, significant differences between AZD9567 and prednisolone were also seen for the change from baseline to day 4 in insulin and glucagon secretion postmeal (P < .001 and P = .005, respectively) and change from baseline to Day 4 in GLP-1 response (P = .022). Significant differences between AZD9567 and prednisolone for 24-h glucose control were observed for both cohort 1 (-1.507 mmol/L; 95% CI: -2.0820, -0.9314; P < .001) and cohort 2 (-1.110 mmol/L; 95% CI -1.7257, -0.4941; P < .001).

CONCLUSION: AZD9567 significantly reduced treatment-induced hyperglycaemia compared with prednisolone.

PMID:38690606 | DOI:10.1111/bcp.16082

Front Pediatr. 2024 Apr 16;12:1333652. doi: 10.3389/fped.2024.1333652. eCollection 2024.

ABSTRACT

OBJECTIVE: Elastic stable intramedullary nail (ESIN) is a commonly used method for treating diaphyseal fractures of the tibia, but its application in Distal Tibial Diaphyseal Metaphyseal Junction (DTDMJ) fractures has been a subject of controversy. This study aims to evaluate the clinical efficacy of the Elastic stable intramedullary nail-Kirschner wire (E-K) technique in treating pediatric DTDMJ fractures, providing better clinical decision-making for clinicians in diagnosing and treating such fractures.

METHODS: We conducted a retrospective analysis of patients aged 3-9 years who received treatment at our hospital from January 2019-January 2021 for distal tibial diaphyseal metaphyseal junction (DTDMJ) fractures. Based on their surgical procedures, they were categorized into the Elastic Stable Intramedullary Nail-Kirschner wire group (E-K) and the ESIN group. Demographic data, surgical duration, clinical outcomes, complications, and imaging data were recorded.

RESULTS: The study included a total of 57 patients, with 24 cases in the E-K group and 33 cases in the ESIN group. There were 30 males and 27 females. The average age was (6.25 ± 1.59) years in the E-K group and (6.27 ± 1.48) years in the ESIN group. There were no significant differences between the two groups in terms of gender, age, weight, time from injury to surgery, follow-up time, side of injury, associated injuries, nail site infection, deep infection, and nail removal time (P > 0.05). Neither group experienced nonunion or refracture. The E-K group exhibited significantly lower coronal and sagittal plane angular values at the final follow-up compared to the ESIN group (P < 0.001). In the E-K group, the final follow-up coronal plane angle was 2.67 (1.09)°, while in the ESIN group, it was 6.55 (2.05)°. The final follow-up sagittal plane angle was 3.12 (1.54)° in the E-K group and 7.58 (1.48)° in the ESIN group. Both groups showed good alignment in the initial postoperative x-rays, with no statistically significant differences. However, during clinical healing, the ESIN group exhibited significant displacement, whereas the E-K group had minimal displacement, demonstrating a significant statistical difference (P < 0.001). There was a statistically significant difference in the AOFAS joint function assessment between the two groups (P = 0.027).

CONCLUSION: The E-K technique is a viable option for treating DTDMJ fractures in pediatric patients, with well-established clinical efficacy. Its advantages include a straightforward surgical procedure, safety, and a low incidence of severe complications.

PMID:38690522 | PMC:PMC11058844 | DOI:10.3389/fped.2024.1333652

Cureus. 2024 Mar 31;16(3):e57300. doi: 10.7759/cureus.57300. eCollection 2024 Mar.

ABSTRACT

Background Temporomandibular joint disorders (TMD) represent a prevalent group of conditions impacting the temporomandibular joint. Among the therapeutic interventions, occlusal splint therapy has gained recognition for its potential to address TMD symptoms, particularly in cases involving joint displacement. Objective This study aims to investigate the effectiveness of occlusal splint therapy in cases of moderate TMD with joint displacement, focusing on changes in condylar position, joint morphology, and patient-reported outcomes. Methods A retrospective analysis was conducted involving 148 participants who underwent occlusal splint therapy between January 2018 and December 2020. Data were collected through cone beam computed tomography (CBCT) imaging for precise assessments of condylar position and joint morphology. Ethical approval was obtained, and participants provided informed consent. Baseline characteristics, medical history, and TMD severity were recorded. Occlusal splint therapy included individualized fabrication, occlusal analysis, adjustments for optimal fit, and prescribed wear schedules. Follow-up included CBCT scans at specified intervals (three months and six months), with participant-reported outcomes collected. The data analysis was conducted using IBM SPSS Statistics for Windows, Version 22.0 (Released 2013; IBM Corp., Armonk, NY, USA). Paired t-tests or nonparametric equivalents were employed to assess changes in condylar position and joint morphology. Subgroup analyses were conducted to explore potential factors influencing treatment outcomes. The significance level was set at p < 0.05 for all statistical tests. Results The entire cohort (n = 148) had a mean age of 32.5 years (± 8.1), with a balanced gender distribution. Changes in condylar position revealed a statistically significant improvement (p = 0.03), with a mean decrease of 0.2 mm posttreatment. Joint morphology changes indicated increased joint space width (p = 0.01), improved disc position (p = 0.02), and nonsignificant alterations in bony structures (p = 0.10). Patient-reported outcomes demonstrated significant improvements in pain levels, jaw functionality, and satisfaction (all p < 0.001). Age and gender subgroup analyses showed consistent improvements in condylar position, joint morphology, and patient-reported outcomes across different groups. Conclusion Occlusal splint therapy demonstrated effectiveness in improving condylar position, joint morphology, and patient-reported outcomes in cases of moderate TMD with joint displacement. The findings underscore the potential of occlusal splint therapy as a viable intervention for managing TMD, providing valuable insights for clinicians and researchers.

PMID:38690507 | PMC:PMC11059150 | DOI:10.7759/cureus.57300