Nevin Manimala

J Cosmet Dermatol. 2024 Aug 13. doi: 10.1111/jocd.16498. Online ahead of print.

ABSTRACT

BACKGROUND: Rosacea can be seen in many patients nowadays, and the related causes are complex. Despite a certain association between smoking and rosacea being reported by several studies, the actual causality has not been established for the possible bias and confounders.

METHODS: We used Mendelian randomization (MR) to evaluate a potential causal effect of smoking on rosacea risk. Statistics on smoking and rosacea were obtained from the FinnGen project and Neale Lab Consortium. The causal association was assessed by multiple methods including inverse variance weighted (IVW), MR Egger, weighted median, and weighted mode. Furthermore, sensitivity analyses were also conducted to address pleiotropy, along with the leave-one-out method.R version 4.2.3 was applied for the analyses.

RESULTS: The IVW estimation revealed that previous smoking has a deleterious effect on rosacea (odds ratio [OR] = 6.7729, 95% confidence interval [CI] = 1.5691-29.2356, p = 0.0104). By contrast, there was no statistically relationship between current smokers and rosacea (OR = 0.6180, 95% CI = 0.0605-6.3094, p = 0.6847). Results were similar in the analysis based on the weighted median method (previous smoking: OR = 8.6297, 95% CI = 1.0131-73.5071, p = 0.0486; current smoking: OR = 0.2896, 95% CI = 0.0106-7.9132, p = 0.4627). The stability of the causal effect estimates was supported by several sensitivity analyses and the leave-one-out method.

CONCLUSION: Our MR study found support forrosacea risk and previous smoking. Although no evidence was found to increase the risk of rosacea in current smokers, to prevent various diseases associated with smoking, the public should be encouraged to avoid smoking at the very beginning.

PMID:39136194 | DOI:10.1111/jocd.16498

J Gastroenterol Hepatol. 2024 Aug 13. doi: 10.1111/jgh.16685. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: Currently, the primary treatment modality for patients with colorectal adenocarcinoma (CRA) is radical surgery combined with postoperative adjuvant chemotherapy (PAC). However, many elderly patients decline PAC due to concerns about their underlying physiological condition, and the impact of PAC on the prognosis of elderly patients remains uncertain.

METHODS: We extracted data from the SEER database for CRA patients aged 75 and above between 2010 and 2019. Utilizing propensity score matching (PSM), we stratified the patients into a PAC group and a non-PAC group, enabling us to compare the differences in Kaplan-Meier survival curves between these two groups. Furthermore, through univariate and multivariate Cox regression analyses, we identified the clinical factors that influence the survival of elderly CRA patients and compared the prognostic disparities between the two patient groups within specific subgroups of these clinical factors.

RESULTS: Following PSM, a total of 3668 patients were included and divided into the PAC group and the non-PAC group, with no statistically significant differences observed in crucial clinical characteristics between the two groups. Kaplan-Meier analysis revealed a significantly better prognosis for patients in the PAC group compared with those in the non-PAC group. In addition, age, chemotherapy, TNM staging, gender, and preoperative CEA levels were all identified as important factors affecting patient prognosis. Moreover, PAC provided survival benefits across the majority of levels within the aforementioned subgroups. However, in specific subgroups (age > 90, Grade IV stage, median household income < $40 000), PAC did not confer any survival benefits.

CONCLUSION: PAC can significantly improve the prognosis of elderly CRA patients. Nonetheless, in certain population subsets characterized by specific clinical features, PAC does not provide any survival benefits.

PMID:39136187 | DOI:10.1111/jgh.16685

Dalton Trans. 2024 Aug 13. doi: 10.1039/d4dt01498g. Online ahead of print.

ABSTRACT

A high-temperature synthetic approach is used to prepare a series of pseudo-binary phases-Co_2-xNi_xZn₁₁. In the structures of Co_2-xNi_xZn₁₁, the statistical distribution between Co and Ni that is suggested by compositional analysis is confirmed by combined refinements of X-ray and neutron powder diffraction (NPD) experimental data. The aforementioned phases adopt a body-centered cubic lattice with a noncentrosymmetric space group I4̄3m (217). Their crystal structures comprise two 26-atom γ-brass clusters. Each γ-cluster is made of four sequential polyhedral shells: inner tetrahedron (IT), outer tetrahedron (OT), octahedron (OH), and distorted cuboctahedron (CO). Diffraction experiments and the computations endorse that the OT site is statistically distributed by Co and Ni atoms, while the other three sites (IT, OH, and CO) are occupied by Zn atoms. The density of states (DOS) curve for Co_1.5Ni_0.5Zn₁₁ displays a similar feature as binary Co₂Zn₁₁, whereas the wide pseudo-gap is formed near E_F as Ni-concentration increases in Co_2-xNi_xZn₁₁. Bonding analysis shows that this specific atomic distribution nearly optimizes heteroatomic Co/Ni-Zn contacts in the Co_1.0Ni_1.0Zn₁₁ and Co_0.5Ni_1.5Zn₁₁. The Co_1.7Ni_0.3Zn₁₁ exhibit paramagnetic behavior, whereas Co_0.5Ni_1.5Zn₁₁ shows distinct diamagnetic behavior. With the increase in Ni concentration in the structure of Co_2-xNi_xZn₁₁, Ni atoms gradually substitute the Co atoms at OT sites; hence, magnetic characteristics change from para- to diamagnetism.

PMID:39136138 | DOI:10.1039/d4dt01498g

Hypertension. 2024 Aug 13. doi: 10.1161/HYPERTENSIONAHA.124.23397. Online ahead of print.

ABSTRACT

BACKGROUND: Home blood pressure (BP) is more closely associated with cardiovascular event risk than office BP, but cardiovascular risk prediction based on home BP variability is lacking. This study developed a simple cardiovascular event prediction score, including home BP variability data, from the J-HOP study (Japan Morning Surge-Home Blood Pressure).

METHODS: The J-HOP study extended follow-up from December 2017 to May 2018 generated the study data set (4231 patients). Cardiovascular events included fatal/nonfatal stroke (n=94), coronary heart disease (n=124), heart failure (n=42), and aortic dissection (n=8). Cox proportional hazards models were used to predict overall cardiovascular risk. Potential covariates included age, sex, body mass index, smoking, history of diabetes, statin use, history of cardiovascular disease, total cholesterol:high-density lipoprotein cholesterol ratio, office systolic BP (SBP), mean of morning-evening average (MEave), home SBP, and average real variability of MEave home SBP. A risk score and models were constructed, and model performance was assessed.

RESULTS: Model performance was best when average real variability of MEave SBP was included (C statistic, 0.760). The risk score assigns points for age (5-year bands), sex, cardiovascular disease history, high-density lipoprotein cholesterol, mean MEave home SBP, and average real variability of MEave home SBP. Estimated 10-year cardiovascular risk ranged from ≤0.6% (score ≤0) to >32% (score ≥26). Calibration 2 statistics values for the model (2.66) and risk score (5.29) indicated excellent goodness of fit.

CONCLUSIONS: This simple cardiovascular disease prediction algorithm, including day-by-day home BP variability, could be used as part of a home BP-centered approach to hypertension management in clinical practice.

PMID:39136129 | DOI:10.1161/HYPERTENSIONAHA.124.23397

Intern Med J. 2024 Aug 13. doi: 10.1111/imj.16488. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: Patients with autoimmune inflammatory rheumatic disease (AIIRD) are at higher risk of severe infections because of their underlying diseases and immunosuppression. Our objective was to elucidate the epidemiological and clinical characteristics of patients with AIIRD presenting with COVID-19 and their relation to disease severity. We explored whether variables, including underlying diagnosis, disease-modifying antirheumatic drugs (DMARDs) and COVID-19 vaccine status, were associated with more severe forms of COVID-19 infection.

METHODS: Between 1 January 2020 and 30 June 2022, 151 patients with AIIRD and COVID-19 infection were analysed using a binary regression model and a multinomial regression model.

RESULTS: The average age was 61.5 years, and average Charlson Comorbidity Index (CCI) was 2.1; 106 (70.2%) patients were diagnosed with rheumatoid arthritis (RA), and 70 (46.4%) patients were receiving prednisolone. In the multivariable logistic regression model, ages between 50 and 69 years (odds ratio (OR) = 5.85; 95% confidence interval (CI) = 1.35-25.25) and older than 70 years (OR = 5.29; 95% CI = 1.21-23.14), prior prednisolone treatment (OR = 7.09; 95% CI = 2.63-19.11) and vaccination status including one and two doses (OR = 0.19; 95% CI = 0.05-0.69) and three and four doses (OR = 0.09; 95% CI = 0.02-0.35) were all statistically significant factors related to changes in the severity level of COVID-19.

CONCLUSION: Severity of COVID-19 infection in patients with AIIRD is affected by age, background steroid use and vaccination status. Factors including sex, comorbidity, diagnosis of AIIRDs and use of DMARDs, including conventional synthetic, biologics and targeted DMARDs, were not significantly associated with COVID-19 severity.

PMID:39136111 | DOI:10.1111/imj.16488

J Athl Train. 2024 Aug 13. doi: 10.4085/1062-6050-0135.24. Online ahead of print.

ABSTRACT

CONTEXT: Extensive research has exposed healthcare disparities regarding socioeconomic status (SES) and race/ethnicity demographics. Previous research has shown significant differences in access to athletic training services (AT access) in the secondary school setting based on SES, but with limited samples.

OBJECTIVE: This study investigated differences in AT access based on race/ethnicity and SES on a national scale.

DESIGN: Cross-sectional study.

SETTING: Database study using secondary analysis. Data were collected from the National Center for Education Statistics (NCES), Athletic Training Location and Services (ATLAS) database, and US Census Bureau.

PATIENTS OR OTHER PARTICIPANTS: 10,983 public schools.

MAIN OUTCOME MEASURE: Descriptive data was summarized by measures of central tendency. A one-way ANOVA determined differences between school characteristics: median household income (MHI), percent of students eligible for free and reduced lunch (%FRL), percent white students, and percent non-white students based on AT access: Full-time (FT-AT), part-time (PT-AT), and no athletic trainer (no-AT). A Bonferroni pairwise comparison was used for variables with significant main effects.

RESULTS: Across all schools included in the study, 43.8% had no-AT (n=4,812), 23.5% had PT-AT access (n=2,581), and 32.7% had FT-AT access (n=3,590). There were significant effects between AT access and MHI (p<.001), %FLR (p<.001), percent white (p<.001), and percent non-white (p<.001). FT-AT schools had a higher SES when compared to PT-AT and no-AT schools. Significant differences existed between AT access groups and race/ethnicity of schools. Schools with FT-AT had a significantly lower percent of non-white students (31.3%) compared to schools with no-AT (46.0%) (p<.001). No significant differences between FT-AT and PT-AT based on race/ethnicity demographics presented (p≥.13).

CONCLUSION: Schools with higher SES had greater AT access; whereas, schools with a higher percentage of non-white students were more likely to have no AT access, demonstrating the disparities in healthcare extends to athletic healthcare as well. To increase AT access, future initiatives should address the inequities where larger minority populations and counties of lower SES exist.

PMID:39136089 | DOI:10.4085/1062-6050-0135.24

Front Immunol. 2024 Jul 29;15:1424648. doi: 10.3389/fimmu.2024.1424648. eCollection 2024.

ABSTRACT

BACKGROUND: Previous studies reported that endometriosis may have a higher risk of arthritis. However, it remains unclear whether the association between endometriosis and arthritis has genetic correlations, or the relationship is causal. Linkage Disequilibrium Score (LDSC) and Mendelian Randomization (MR) analyses use genetic variation as a natural experiment to explore genetic correlations and causal inferences from observational data, reducing unmeasured confounding factors.

METHOD: Participants (aged 20-54 years, n = 2,915) for the cross-sectional study were obtained from the National Health and Nutrition Examination Survey (NHANES). Endometriosis and arthritis were diagnosed based on self-reported by reproductive health and medical condition questionnaire. Weighted multivariable logistic regression was used to explore the relationship between endometriosis and arthritis. LDSC and MR analysis were performed using the genome-wide association study (GWAS) summary statistics to identify the causal association.

RESULT: A significant positive association between endometriosis and arthritis was found after multivariable adjustment (OR = 1.89; 95% CI: 1.33, 2.67). When exploring different types of arthritis, a positive association was revealed with rheumatoid arthritis (RA), other types of arthritis, and cases that the arthritis type were unknown, with an OR of 2.07 (95% CI: 1.03, 4.17), 2.78 (95% CI: 1.30, 5.95), and 2.06 (95% CI: 1.36, 3.11), respectively. However, genetic correlation analysis between endometriosis and RA did not reveal any significant findings (all P values > 0.05). Moreover, MR analysis also failed to identify a causal relationship between endometriosis and RA (all P values > 0.05).

CONCLUSION: Cross-sectional study identified a significant positive association between endometriosis and arthritis among US women, especially among RA, while findings based on LDSC and MR analysis did not support a genetic correlation or causal role. These findings suggest that clinicians should pay more attention to the coexistence of RA in endometriosis patients and explore the shared pathophysiological mechanisms of these two disorders, with a particular focus on extrinsic factors rather than intrinsic genetic inheritance.

PMID:39136014 | PMC:PMC11317389 | DOI:10.3389/fimmu.2024.1424648

Front Immunol. 2024 Jul 29;15:1381091. doi: 10.3389/fimmu.2024.1381091. eCollection 2024.

ABSTRACT

INTRODUCTION: SARS-CoV-2 pandemic still poses a significant burden on global health and economy, especially for symptoms persisting beyond the acute disease. COVID-19 manifests with various degrees of severity and the identification of early biomarkers capable of stratifying patient based on risk of progression could allow tailored treatments.

METHODS: We longitudinally analyzed 67 patients, classified according to a WHO ordinal scale as having Mild, Moderate, or Severe COVID-19. Peripheral blood samples were prospectively collected at hospital admission and during a 6-month follow-up after discharge. Several subsets and markers of the innate and adaptive immunity were monitored as putative factors associated with COVID-19 symptoms.

RESULTS: More than 50 immunological parameters were associated with disease severity. A decision tree including the main clinical, laboratory, and biological variables at admission identified low NK-cell precursors and CD14⁺CD91⁺ monocytes, and high CD8⁺ Effector Memory T cell frequencies as the most robust immunological correlates of COVID-19 severity and reduced survival. Moreover, low regulatory B-cell frequency at one month was associated with the susceptibility to develop long COVID at six months, likely due to their immunomodulatory ability.

DISCUSSION: These results highlight the profound perturbation of the immune response during COVID-19. The evaluation of specific innate and adaptive immune-cell subsets allows to distinguish between different acute and persistent COVID-19 symptoms.

PMID:39136010 | PMC:PMC11317765 | DOI:10.3389/fimmu.2024.1381091

Front Neuroanat. 2024 Jul 29;18:1398858. doi: 10.3389/fnana.2024.1398858. eCollection 2024.

ABSTRACT

INTRODUCTION: The triangular recess (TR), also called triangular fossa or vulva cerebri, represents the anterior extension of the diencephalic ventricle, located between the anterior columns of the fornix and the anterior white commissure. Over time, this structure of the third cerebral ventricle generated many disputes. While some anatomists support its presence, others have opposite opinions, considering that it only becomes visible under certain conditions. The aim of the study is to demonstrate the tangible structure of the triangular recess. Secondly, the quantitative analysis allowed us to establish an anatomical morphometric standard, as well as the deviations from the standard.

MATERIALS AND METHODS: Our study is both a quantitative and a qualitative evaluation of the triangular fossa. We dissected 100 non-neurological adult brains, which were fixed in 10% formaldehyde solution for 10 weeks. The samples are part of the collection of the Institute of Anatomy, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi. We highlighted the triangular fossa by performing dissections in two stages at the level of the roof of the III ventricle.

RESULTS: The qualitative analysis is a re-evaluation of the classical data concerning the anatomy of the fossa triangularis. We proposed an original 3D model of the triangular recess in which we described a superficial part called vestibule and a deep part called pars profunda. We measured the sides of the communication between the two proposed segments, as well as the communication with the III ventricle. By applying the Heron’s formula, we calculated the area of the two communications. Statistical evaluations have shown that these communications are higher than they are wide. In addition, there is a statistical difference between the surfaces of the two communications: 34.07 mm² ± 7.01 vs. 271.43 mm² ± 46.36 (p = 0.001).

CONCLUSION: The outcome of our study is both qualitative and quantitative. Firstly, we demonstrated the existence of the triangular fossa and we conceived a spatial division of this structure. Secondly, the measurements carried out establish an anatomo-morphometric norm of the triangular recess, which is useful in assessing the degree of hydrocephalus during the third endoscopic ventriculoscopy.

PMID:39135984 | PMC:PMC11317240 | DOI:10.3389/fnana.2024.1398858

Ther Clin Risk Manag. 2024 Aug 8;20:473-482. doi: 10.2147/TCRM.S468598. eCollection 2024.

ABSTRACT

BACKGROUND: Robotic-assisted total knee arthroplasty (RATKA) has been reported to enhance operative decision-making. The purpose of this study was intended to assess the predictive accuracy of bone cuts, lower limb alignment, and component size of a novel system for RATKA preoperatively and intraoperatively.

METHODS: Preoperatively planned bone cuts, limb alignment, and component size were projected using a reconstructed 3D model. Intraoperative bone cuts and postoperative limb alignment were measured. Errors between planned and real bone cuts, limb alignment, and component size were compared.

RESULTS: The mean absolute errors for bone cuts and alignment were within 1.40mm/1.30° with a standard deviation (SD) of 0.96mm/1.12°. For all errors of bone cuts and alignment compared with the plan, there were no statistically significant differences except for the lateral distal of femoral cuts (P=0.004). The accuracy for predicting the femoral, tibial, and polyethylene component sizes was 100% (48/48), 90% (43/48), and 88% (42/48), respectively. Regarding all mean absolute errors of bone cuts and alignments, no significant differences were observed among surgeons.

CONCLUSION: The novel robotically-assisted system for RATKA donated reliable operative decision-making based on the predictive accuracy regardless of the surgeon’s level of experience.

PMID:39135983 | PMC:PMC11318605 | DOI:10.2147/TCRM.S468598