Nevin Manimala

Retina. 2024 Sep 1;44(9):1633-1638. doi: 10.1097/IAE.0000000000004141.

ABSTRACT

PURPOSE: To identify longitudinal retinal layer thickness changes in normal eyes of cognitively healthy elderly people.

METHODS: Post hoc analysis was performed on 57 cognitively healthy elderly participants from the population-based Korean Longitudinal Study on Health and Aging and Korean Longitudinal Study on Cognitive Aging and Dementia cohort studies who underwent baseline and final optical coherence tomography scans. The peripapillary retinal nerve fiber layer, subfoveal choroid, and average retinal layer thickness at four quadrant (nasal, temporal, superior, and inferior) points 1 mm, 2 mm, and 3 mm from the center of the fovea were measured.

RESULTS: The mean age of subjects was 75.1 years and the mean follow-up period was 55.9 months. Among the analyzed retinal layers, both the ganglion cell-inner plexiform layer and the outer nuclear layer at all 1 mm, 2 mm, and 3 mm points showed a statistically significant decrease in thickness at the final visit compared with baseline. The annual decrease rates were -1.2 µm/year at 1 mm (total -6.6%), -1.3 µm/year at 2 mm (total -8.4%), and -1.1 µm/year at 3 mm (total -9.7%) for ganglion cell-inner plexiform layer and -0.6 µm/year at 1 mm (total -4.2%), -0.5 µm/year at 2 mm (total -3.9%), and -0.4 µm/year at 3 mm (total -4.1%) for outer nuclear layer.

CONCLUSION: Aging plays a significant role in the reduction of ganglion cell-inner plexiform layer and outer nuclear layer thicknesses in cognitively healthy elderly individuals.

PMID:39167584 | DOI:10.1097/IAE.0000000000004141

Neuroreport. 2024 Jul 24. doi: 10.1097/WNR.0000000000002079. Online ahead of print.

ABSTRACT

We investigated differences in subcortical white matter according to the presence disorders of consciousness (DOC) in patients with hypoxic-ischemic brain injury (HI-BI), using tract-based spatial statistics (TBSS). Thirty-two consecutive patients with HI-BI were recruited. The patients were assigned in group A [preserved consciousness (Glasgow Coma Scale: 15 and Coma Recovery Scale-revised (CRS-R): 23, 9 patients)] or group B [DOC present (Glasgow Coma Scale <15 and CRS-R < 23, 20 patients)]. Voxel-wise statistical analysis of fractional anisotropy data was performed by using TBSS as implemented in the FMRIB Software Library. We calculated mean fractional anisotropy values across the white matter skeleton and within 48 regions of interest (ROIs) based on intersections between the skeleton and the probabilistic Johns Hopkins University white matter atlases. Among the 48 ROIs examined, the fractional anisotropy values of two ROIs (the left superior corona radiata, and left tapetum) were significantly lower in group B than in group A (P < 0.05). No significant differences were observed, however, in the other 46 ROIs (P > 0.05). Our results suggest that abnormalities of the superior corona radiata and tapetum may be critical for DOC presence in patients with HI-BI.

PMID:39166416 | DOI:10.1097/WNR.0000000000002079

Eur J Gastroenterol Hepatol. 2024 Aug 19. doi: 10.1097/MEG.0000000000002810. Online ahead of print.

ABSTRACT

OBJECTIVE: The breadth and validity of the associations of nongenetic risk factors with celiac disease (CeD) are elusive in the literature. We aimed to evaluate which of these associations have strong epidemiological credibility and assessed presence and extent of potential literature biases.

METHODS: We systematically searched PubMed until April 2024 for systematic reviews and meta-analyses of studies examining associations between putative risk factors and CeD. Each association was categorized in five evidence grades (convincing, highly suggestive, suggestive, weak, and not statistically significant) based on broadly used criteria for evaluating quality of evidence in observational studies.

RESULTS: Five eligible publications were included, describing 15 meta-analytic associations on seven nongenetic risk factors, three of which were nominally significant (P < 0.05). None of the associations received a strοng or highly suggestive evidence. One meta-analytic association received suggestive evidence, namely any infections during childhood and adulthood for a higher risk of CeD (OR, 1.37; 95% CI, 1.2-1.56; P=3.77 × 10-6). Two meta-analyses reported weak evidence, pertaining to current smoking for a lower risk of CeD (OR, 0.52; 95% CI, 0.32-0.84; P=7.84 × 10-3) and use of antibiotics for a higher risk (OR, 1.2; 95% CI, 1.04-1.38; P 14.8 × 10-3). The rest of the meta-analyses did not report statistically significant results, and pertained to breastfeeding, time of gluten introduction, rotavirus vaccination, and cesarean section.

CONCLUSION: No association of nongenetic risk factors for CeD received high levels of evidence. The evidence was suggestive for the association of any infections during childhood and adulthood with higher risk of CeD. More and prospective future research is warranted.

PMID:39166402 | DOI:10.1097/MEG.0000000000002810

Biomed Mater. 2024 Aug 21;19(5). doi: 10.1088/1748-605X/ad6dc3.

ABSTRACT

Melanoma is a common malignant tumor, with a five-year mortality rate as high as 62% in cases of metastatic melanoma according to cancer statistics (2024). In recent years, the focus of melanoma research has predominantly centered on immunotherapy and targeted therapy, grappling with challenges such as resistance and immunogenicity. The discovery of nanoparticles (NPs) has brought nano-delivery systems to the forefront of melanoma diagnosis and treatment. Although certain NPs, like liposomes, have gained clinical approval, utilizing most nano-delivery systems for melanoma diagnosis and treatment remains largely exploratory. The inherent limitations of NPs present a major obstacle to their clinical translation. By selecting suitable nanocarriers and functionalizing NPs to optimize nano-delivery systems, and combining these systems with other therapies, it is possible to reduce the systemic toxicity and resistance associated with conventional therapies and the NPs themselves. This optimization could significantly improve the effectiveness of nano-delivery systems in the early detection and timely treatment of melanoma. However, there have been few reviews on the optimization of NPs and the combined application of other therapies in the treatment and diagnostic application of melanoma in the past three years. This review summarizes the latest applications of nano-delivery systems in the diagnosis and treatment of melanoma over the past three years, including innovations and achievements in both preclinical and clinical studies, offering new perspectives on their potential and future application prospects. It integrates clinical data and patent information, highlights trends in nano-delivery system development, and offers new insights into their clinical translation. Additionally, it discusses the challenges and opportunities of nano-delivery systems in melanoma treatment, providing a foundation for advancing their application in diagnosis, treatment, and clinical translation.

PMID:39166400 | DOI:10.1088/1748-605X/ad6dc3

J Cardiovasc Med (Hagerstown). 2024 Aug 14. doi: 10.2459/JCM.0000000000001661. Online ahead of print.

ABSTRACT

BACKGROUND: Clinical complications of anorexia nervosa (AN) include cardiac structural and functional alterations. Available evidence on impaired myocardial deformation in AN patients without overt systolic dysfunction as assessed by left ventricular ejection fraction (LVEF) is scanty and based on a few studies. The aim of the present meta-analysis was to provide comprehensive and updated information on this issue.

METHODS: Following the PRISMA guidelines, systematic searches were conducted across bibliographic databases (Pub-Med, OVID, EMBASE and Cochrane library) to identify eligible studies from inception up to 31 January 2024. Searches were limited to clinical investigations published in English reporting data on left ventricular (LV) mechanics (i.e. global longitudinal strain) in patients with anorexia and controls. The statistical difference of the echocardiographic variables of interest between groups such as LVEF and global longitudinal strain (GLS) was calculated by standardized mean difference (SMD) with 95% confidence interval (CI) by using random-effects models.

RESULTS: Five studies including 171 AN and 147 healthy normal-weight individuals were considered for the analysis. Pooled average LVEF values were 63.2 ± 0.4% in the healthy control group and 64.6 ± 1.0% in the AN group (SMD -0.08 ± 0.11, CI: -0.15/0.30, P = 0.51); the corresponding values of GLS were -20.1 ± 0.9% and -20.2 ± 0.9% (SMD 0.07 ± 0.3, CI: -0.46/0.60, P = 0.80). Unlike GLS, apical strain (data from three studies) was higher in AN than in controls (-23.1 ± 1.8 vs. -21.3 ± 1.8; SMD: -0.42 ± 0.17, CI: -0.08/-0.76, P = 0.01).

CONCLUSIONS: The results of the present meta-analysis do not support the view that myocardial deformation as assessed by GLS is impaired in patients with AN and preserved LVEF. The role of STE in detecting subclinical cardiac damage in this clinical condition deserves to be evaluated in future studies including regional LV strain.

PMID:39166392 | DOI:10.2459/JCM.0000000000001661

Expert Rev Proteomics. 2024 Aug 21. doi: 10.1080/14789450.2024.2395398. Online ahead of print.

ABSTRACT

INTRODUCTION: Oral squamous cell carcinoma (OSCC) represents the most prevalent form of oral cancer. Potentially malignant disorders of oral mucosa exhibit an elevated propensity for malignant progression. A substantial proportion of cases are discerned during advanced stages, significantly impacting overall survival. This investigation aims to ascertain salivary metabolites with potential utility in the early detection of OSCC.

METHODS: A search encompassing PubMed, EMBASE, Scopus, Ovid, Science Direct, and Web of Science databases was conducted to identify eligible articles. The search strategy employed precise terms. The quality assessment of the included studies was executed using the QUADAS 2 ROB tool. This was registered with PROSPERO CRD42021278217.

RESULTS: Upon removing duplicate articles and publications that didn’t satisfy the inclusion criteria, seven articles were included in the current study. The Random Effects Maximum Likelihood (REML) model adopted for quantitative synthesis identified N-acetyl glucosamine as the sole metabolite in two studies included in this meta-analysis. The pathways significantly influenced by these identified metabolites were delineated.

CONCLUSION: This study highlights N-acetyl glucosamine as a distinctive metabolite with the potential to serve as an early diagnostic marker for OSCC. Nevertheless, further research is warranted to validate its clinical utility.

PMID:39166387 | DOI:10.1080/14789450.2024.2395398

Head Neck. 2024 Aug 21. doi: 10.1002/hed.27916. Online ahead of print.

ABSTRACT

INTRODUCTION: In the management of sinonasal malignancies treatment-induced morbidity and mortality is gaining relevance both for surgical approaches (endoscopic and open resection) and non-surgical therapies. The aim of this multicenter study is to assess complications associated with endoscopic surgery and non-surgical treatments (neoadjuvant and/or adjuvant) for malignant sinonasal tumors.

METHODS: All patients with nasoethmoidal malignancies treated with curative intent with endoscopic or endoscopic-assisted surgery at three referral centers with uniform management policies were included. Neo- and/or adjuvant (chemo)radiotherapy was administered according to histology and pathological report. Demographics, treatment characteristics, and complications related both to the surgical and non-surgical approaches were retrieved. The data were analyzed with univariate and multivariate statistics to assess independent predictors of complications.

RESULTS: Nine hundred and forty patients were included, 643 males (68%) and 297 females (32%). A total of 225 complications were identified in 187 patients (19.9%): cerebrospinal fluid (CSF) leak (3.5%), mucocele (2.3%), surgical site bleeding (2.0%), epiphora (2.0%), and radionecrosis (2.0%) were the most common. Treatment-related mortality was 0.4%. Variables independently associated with complications at multivariate analysis were principally dural resection (OR 1.92), cranioendoscopic or multiportal resection (OR 2.93), dural repair with multilayer technique with less than three layers (OR 2.17), and graft different from iliotibial tract (OR 3.29).

CONCLUSION: Our study shows that modern endoscopic treatments and radiotherapy for sinonasal malignancies are associated with limited morbidity and treatment-related mortality. CSF leak and radionecrosis, although rare, remain the most frequent complications and should be further addressed by future research efforts.

PMID:39166378 | DOI:10.1002/hed.27916

Nurs Open. 2024 Aug;11(8):e70003. doi: 10.1002/nop2.70003.

ABSTRACT

AIMS: To investigate the relationships among communication competence, professional autonomy and clinical reasoning and to identify the factors that influence clinical reasoning competence in oncology nurses.

DESIGN: Cross-sectional descriptive design.

METHODS: Participants included 147 oncology nurses with more than a year of clinical experience in cancer wards. The Global Interpersonal Communication Competence Scale, Schutzenhofer Professional Autonomy Scale and Nurses Clinical Reasoning Scale (NCRS) were used to collect data. Data were analysed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation analysis and hierarchical multiple regression analysis.

RESULTS: Communication competence (r = 0.59) and professional autonomy (r = 0.46) showed significant positive relationships with clinical reasoning competence. Clinical experience, communication competence, age and professional autonomy were statistically significant predictors and explained 48.6% of clinical reasoning competence.

CONCLUSIONS: The clinical reasoning competence of oncology nurses increases proportionally with their communication competence and professional autonomy. Therefore, oncology nurses must reinforce their communication competence and professional autonomy to enhance their clinical reasoning competence.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The reinforcement of communication competence and professional autonomy is necessary for oncology nurses to enhance their clinical reasoning competence. In order to improve nurses’ communication competence, practical-focused communication education programmes must be designed and deployed systematically and periodically. In addition, to increase nurses’ professional autonomy, it is necessary to expand their clinical experiences through the regular rotation of working units and to make institutional efforts to retain experienced nurses.

REPORTING METHOD: We have adhered to STROBE checklist.

PATIENT OR PUBLIC CONTRIBUTION: Participants in the study were recruited online. They were informed of the study’s purpose, method and usability and the survey could only be conducted if they consented to participate voluntarily.

PMID:39166373 | DOI:10.1002/nop2.70003

Can J Psychiatry. 2024 Aug 21:7067437241271738. doi: 10.1177/07067437241271738. Online ahead of print.

NO ABSTRACT

PMID:39166343 | DOI:10.1177/07067437241271738

Fa Yi Xue Za Zhi. 2024 Jun 25;40(3):261-268. doi: 10.12116/j.issn.1004-5619.2023.131101.

ABSTRACT

OBJECTIVES: To explore the association between violent behaviors and emotions in individuals with mental disorders, to evaluate the application value of facial expression analysis technology in violence risk assessment of individuals with mental disorders in supervised settings, and to provide a reference for violence risk assessment.

METHODS: Thirty-nine male individuals with mental disorders in supervised settings were selected, the participant risk of violence, cognitive function, psychiatric symptoms and severity were assessed using the Modified Overt Aggression Scale (MOAS), the Historical, Clinical, Risk Management-Chinese version(HCR-CV), the Positive and Negative Syndrome Scale (PANSS) and the Brief Psychiatric Rating Scale (BPRS). An emotional arousal was performed on the participants and the intensity of their emotions and facial expression action units was recorded before, during and after the arousal. One-way analysis of variance (ANOVA) was used to compare the differences in the intensity of emotions and facial expression action units before, during and after the arousal. Pearson correlation analysis was used to calculate the correlations between the intensity of the seven basic emotional facial expressions and the scores of the assessment scales.

RESULTS: The intensity difference of sadness, surprise and fear in different time periods was statistically significant (P<0.05). The intensity of the left medial eyebrow lift action unit was found significantly different before and after the emotional arousal (P<0.05). The intensity of anger was positively correlated with the Modified Overt Aggression Scale score throughout the experiment (P<0.05).

CONCLUSIONS: Eye action units such as eyebrow lifting, eyelid tightening and upper eyelid lifting can be used as effective action units to identify sadness, anger and other negative emotions associated with violent behaviors. Facial expression analysis technology can be used as an auxiliary tool to assess the potential risk of violence in individuals with mental disorders in supervised settings.

PMID:39166307 | DOI:10.12116/j.issn.1004-5619.2023.131101