Nevin Manimala

BMC Gastroenterol. 2024 Dec 31;24(1):483. doi: 10.1186/s12876-024-03577-1.

ABSTRACT

BACKGROUND/AIMS: The increasing use of biologic therapies for moderate to severe inflammatory bowel disease (IBD) highlights the importance of optimal treatment sequencing, particularly after vedolizumab (VDZ) exposure. Studies comparing the effectiveness of ustekinumab (UST) and antitumor necrosis factor (anti-TNF) agents post-VDZ are limited.

METHODS: This retrospective study analyzed VDZ-experienced IBD patients treated with UST or anti-TNF (adalimumab and infliximab) from May 2019 to January 2024. We conducted a comparative analysis of the 52-week treatment persistence between UST and anti-TNF therapies, while also identifying independent predictors that influence 52-week persistence.

RESULTS: The study included 110 participants, with 40 diagnosed with ulcerative colitis (UC) and 70 with Crohn’s disease (CD). Demographics were comparable across treatment groups. The primary discontinuation reason for VDZ was secondary non-response. Kaplan-Meier analysis revealed that UST demonstrated superior 52-week persistence in overall IBD, CD and UC patients, compared to anti-TNF. Cox regression analysis also showed UST’s superiority in overall IBD (HR: 0.15, 95% CI: 0.05-0.45, p < 0.001), CD (HR: 0.09, 95% CI: 0.01-0.68, p = 0.02), and UC (HR: 0.28, 95% CI: 0.08-0.996, p = 0.049). The independent predictors for 52-week treatment persistence are Crohn’s disease (Odds Ratio: 7.151, 95% CI: 1.763-28.995, p = 0.006) and UST treatment (Odds Ratio: 7.912, 95% CI: 1.789-34.992, p = 0.006). Notably, UST required more frequent dosing adjustments than anti-TNF, although both treatments exhibited comparable safety profiles.

CONCLUSIONS: UST demonstrated superior 52-week treatment persistence in IBD patients previously treated with VDZ compared to anti-TNF agents, albeit with a need for more frequent dose adjustments.

PMID:39741232 | DOI:10.1186/s12876-024-03577-1

BMC Infect Dis. 2024 Dec 31;24(1):1481. doi: 10.1186/s12879-024-10351-x.

ABSTRACT

BACKGROUND: The COVID-19 pandemic resulted in the rapid implementation of telemedicine for HIV care at federally qualified health centers (FQHCs) in the United States. We sought to understand use of telemedicine (telephone and video) at two FQHCs in Los Angeles, and the client attitudes towards and experiences with telemedicine as part of future HIV care.

METHODS: We conducted surveys with 271 people living with HIV (PLHIV), with questions covering sociodemographic factors, telemedicine attitudes and experiences, technological literacy, and access to technological resources and privacy. Survey data were analyzed utilizing summary statistics, chi-square analyses, and Fisher’s exact test to understand associations between sociodemographic factors and telemedicine attitudes and experiences.

RESULTS: Sixty percent of the sample had used any telemedicine and, of these, 93% utilized only telephone visits. Almost all respondents (95%, n = 257) had access to a functioning smartphone and self-rated their technological literacy as high. Most had consistent access to privacy (88%, n = 239), and those without privacy noted this as a barrier to the use of telemedicine. The main benefits of telemedicine (compared to in person) were savings of time and money, convenience, and ability to complete appointments as scheduled. Just over half of PLHIV said they would feel more comfortable discussing sensitive topics (e.g., substance use, relationship issues) in person than over telephone (60%, n = 164) or video (55%, n = 151). Despite limited experience with video telemedicine, half of all participants desired a mix of telephone and video visits as part of their future HIV care.

CONCLUSIONS: During a mature phase of the COVID-19 pandemic, PLHIV in our study showed high satisfaction with telemedicine, largely conducted as telephone visits, and high interest in telemedicine visits as a component of their future HIV care. Future studies should explore barriers to implementing video telemedicine in FQHCs and determine telemedicine’s impact on clinical outcomes, including engagement and viral suppression.

PMID:39741230 | DOI:10.1186/s12879-024-10351-x

BMC Psychiatry. 2024 Dec 31;24(1):965. doi: 10.1186/s12888-024-06377-9.

ABSTRACT

BACKGROUND: Smartphone use has rapidly increased worldwide. It was estimated that worldwide use of smartphones surpassed 4.3 billion in 2023, which means 54% of the world’s population now uses smartphones. However, research shows that excessive smartphone use poses health risks and decreases sleep quality, which can be detrimental for students. This study investigates the impact of problematic smartphone usage on health status, mental health, and sleep quality among medical students enrolled in Sudanese universities.

METHODS: A cross-sectional study was conducted from January to March 2024, targeting medical students and recent graduates from Sudanese universities through an online survey. Data were collected using validated scales for smartphone addiction, sleep quality, suboptimal health status, and mental health. Descriptive and correlation analyses were performed using SPSS software v28.0.0.

RESULTS: Out of 231 respondents (69% female, mean age 22.7), 67.6% exhibited high levels of smartphone addiction. Significant correlations were found between smartphone addiction and poor sleep quality (r = 0.462, p < 0.001), suboptimal health (r = 0.527, p < 0.001), and mental health issues (r = 0.365, p < 0.001). Single students had higher addiction and stress scores, while those living in Sudan showed higher suboptimal health scores.

CONCLUSIONS: Problematic smartphone use (PSU) is prevalent among Sudanese medical students, negatively affecting mental health and sleep.

PMID:39741229 | DOI:10.1186/s12888-024-06377-9

Sci Rep. 2024 Dec 30;14(1):31553. doi: 10.1038/s41598-024-82918-2.

ABSTRACT

The study suggests a better multi-objective optimization method called 2-Archive Multi-Objective Cuckoo Search (MOCS2arc). It is then used to improve eight classical truss structures and six ZDT test functions. The optimization aims to minimize both mass and compliance simultaneously. MOCS2arc is an advanced version of the traditional Multi-Objective Cuckoo Search (MOCS) algorithm, enhanced through a dual archive strategy that significantly improves solution diversity and optimization performance. To evaluate the effectiveness of MOCS2arc, we conducted extensive comparisons with several established multi-objective optimization algorithms: MOSCA, MODA, MOWHO, MOMFO, MOMPA, NSGA-II, DEMO, and MOCS. Such a comparison has been made with various performance metrics to compare and benchmark the efficacy of the proposed algorithm. These metrics comprehensively assess the algorithms’ abilities to generate diverse and optimal solutions. The statistical results demonstrate the superior performance of MOCS2arc, evidenced by enhanced diversity and optimal solutions. Additionally, Friedman’s test & Wilcoxon’s test corroborate the finding that MOCS2arc consistently delivers superior optimization results compared to others. The results show that MOCS2arc is a highly effective improved algorithm for multi-objective truss structure optimization, offering significant and promising improvements over existing methods.

PMID:39738304 | DOI:10.1038/s41598-024-82918-2

Sci Rep. 2024 Dec 30;14(1):31727. doi: 10.1038/s41598-024-82531-3.

ABSTRACT

To evaluate the safety and efficacy of the Saroa Surgical Robot System in robot-assisted laparoscopic radical prostatectomy (RARP). We enrolled 60 patients who underwent RARP using either the Saroa (n = 9) or da Vinci Xi (n = 51) systems at Jikei University Kashiwa Hospital from January 2022 to March 2024. We compared preoperative characteristics, perioperative outcomes, complications, and postoperative urinary continence at three months between the two groups. No significant differences were found in preoperative characteristics. The Saroa group had a longer median operative time compared to the da Vinci group. Postoperative urinary continence rates were slightly lower in the Saroa group (77.8 % vs. 84.6%), though not statistically significant. When the tactile feedback function was activated, the organs were grasped with less force compared to when it was off. This study is the first to assess the Saroa system’s effectiveness and safety in RARP. While the system shows promise, especially with tactile feedback that aids in delicate tissue handling, further investigation is needed to evaluate long-term oncological and functional outcomes.

PMID:39738294 | DOI:10.1038/s41598-024-82531-3

Sci Rep. 2024 Dec 30;14(1):31873. doi: 10.1038/s41598-024-83336-0.

ABSTRACT

Preserving the ability to vividly recall emotionally rich experiences contributes to quality of life in older adulthood. While prior works suggest that moderate-intensity physical activity (MPA) may bolster memory, it is unclear whether this extends to emotionally salient memories consolidated during sleep. In the current study, older adults (mean age = 72.3 ± 5.8) completed an overnight polysomnography assessment with emotional memory tested before and after sleep and a self-report questionnaire assessing habitual PA. Results show that better negative emotional memory consolidation was associated with the frequency and duration of MPA. Statistically replacing 30 min of lower-intensity activity with MPA was associated with better negative emotional memory consolidation. MPA may enhance sleep-dependent consolidation of negative memories in older adults, with modest increases in MPA yielding significant consolidation benefits. Findings may guide interventions and inform public health recommendations by demonstrating that substituting even short durations of low-intensity activity for MPA could produce significant cognitive gains in older adulthood.

PMID:39738288 | DOI:10.1038/s41598-024-83336-0

Sci Rep. 2024 Dec 30;14(1):31726. doi: 10.1038/s41598-024-81901-1.

ABSTRACT

Aluminum alloys have promising characteristics which make them more useful in industrial applications for thermal management and entropy of the fluidic system. Hence, the current research deals with the analysis of entropy and thermal performance of (C₂H₆O₂-H₂O)/50:50% saturated by (AA7072/AA7076/Ti₆AI₄V) alloys. Traditional problem modified using enhanced characteristics of ternary alloys and hydrocarbon 50:50% base fluid. Further, significant effects of nonlinear solar radiations, dissipation and convective heat condition effects are also taken in the problem formulation. The developed model analyzed numerically and simulated the results for thermal performance, comparative entropy, shear drag and heat transfer rate. The results revealed that increasing the effects of dissipation energy, thermal radiations and temperature ratio number, the thermal performance of the system enhanced. However, magnetic effects are observed good to control the thermal boundary layer region. The ternary nanofluid showed dominant behavior followed [Formula: see text] and [Formula: see text] in the case of simple fluid which tells that more energy is unavailable to perform work. Further, the ternary nanofluid’s entropy shows that these fluids are more efficient due to cumulative thermal conductivity of (AA7072/AA7076/Ti₆AI₄V) alloys.

PMID:39738278 | DOI:10.1038/s41598-024-81901-1

Sci Rep. 2024 Dec 30;14(1):31598. doi: 10.1038/s41598-024-80074-1.

ABSTRACT

Mucosal injury is common during consensual intercourse and induces an inflammatory response that could contribute to pathogen transmission including HIV. Here, we compared mucosal immune and microbiome responses to experimentally induced mucosal injury between men who have sex with men engaging in receptive anal intercourse (MSM-RAI) and men who do not engage in RAI (controls), all without HIV. Rectal mucosal secretions were collected from adult MSM-RAI (n = 19) and controls (n = 6) via anoscopy before and up to eight days after experimentally induced injury. Mucosal healing was evaluated by repeated injury surface area measurements with digital imaging. MSM-RAI demonstrated overall significantly higher concentrations of pro-inflammatory cytokines and a distinct rectal microbiome compared with controls. Wound healing was numerically faster in MSM-RAI but did not meet statistical significance (p = 0.09). Different cytokine injury response patterns were observed between MSM-RAI and controls; however, IL-6 and IP-10 were important mediators in both groups. Microbial guilds, particularly from the Lachnospiraceae and Prevotellaceae families, were associated with rectal mucosal inflammation. This work is the first experimental study of rectal mucosal injury and the immune environment in healthy humans and provides a more nuanced understanding of rectal mucosal inflammation after injury, which can inform our understanding of HIV transmission.

PMID:39738273 | DOI:10.1038/s41598-024-80074-1

Sci Rep. 2024 Dec 30;14(1):31640. doi: 10.1038/s41598-024-80431-0.

ABSTRACT

This study aimed to calculate Italy’s first national maternal mortality ratio (MMR) through an innovative record-linkage approach within the enhanced Italian Obstetric Surveillance System (ItOSS). A record-linkage retrospective cohort study was conducted nationwide, encompassing all women aged 11-59 years with one or more hospitalizations related to pregnancy or pregnancy outcomes from 2011 to 2019. Maternal deaths were identified by integrating data from the Death Registry and national and regional Hospital Discharge Databases supported by the integration of findings from confidential enquiries conducted through active surveillance. Maternal Mortality Ratio (MMR), direct MMR (DMMR), and causes of maternal death are the study main outcomes. The MMR was found to be 8.4 per 100,000 live births (95% CI 7.5-9.3), significantly higher than the 3.9 per 100,000 (95% CI 3.3-4.5) calculated solely from the Death Registry, with a notable declining trend over the study period. Causes of death have been classified according to the 10th International Classification of Diseases. Within 42 days from pregnancy outcome, leading causes were obstetric haemorrhage, sepsis, and cardiovascular diseases. Late maternal deaths were primarily attributed to suicide, malignancies, and cardiovascular diseases. This integrated methodology provides a comprehensive understanding of maternal mortality trends and causes in Italy, offering valuable insights for countries utilizing or planning enhanced surveillance systems.

PMID:39738258 | DOI:10.1038/s41598-024-80431-0

Sci Rep. 2024 Dec 30;14(1):31797. doi: 10.1038/s41598-024-82892-9.

ABSTRACT

Tropical cyclone risks are expected to increase with climate change. One such risk is extreme ocean waves generated by surface winds from these systems. We use synthetic databases of both historical (1980-2017) and future (2015-2050) tropical cyclone tracks to generate wind fields and force a computationally efficient wave model to estimate significant wave heights across all global tropical cyclone basins. These data are then used to estimate 1 in 100-year return period significant wave height for both the historical period and the future under an SSP585 high emissions scenario. The results show that by 2050, there are projected increases in 100-year significant wave height of up to 1.5 m (10%) in the Eastern and Western Pacific, South Indian and South Pacific Ocean basins. The North Atlantic basin shows no consistent trend, whilst the North Indian basin (particularly the Bay of Bengal) shows a statistically significant decrease in extreme significant wave height. The results represent the first attempt to quantify the magnitude of expected changes in extreme wave height conditions generated by extreme tropical cyclones across all tropical cyclone basins.

PMID:39738255 | DOI:10.1038/s41598-024-82892-9