Nevin Manimala

Pediatr Surg Int. 2024 Aug 17;40(1):231. doi: 10.1007/s00383-024-05824-8.

ABSTRACT

INTRODUCTION: Ulcerative Colitis (UC) is an Inflammatory Bowel Disease (IBD). Surgery is required in cases of severe acute colitis, massive hemorrhage, toxic megacolon, and perforation; in such cases colectomy and JpouchIleoanal anastomosis (IPAA) are performed. The aim of this study was to evaluate functional outcome, and patient satisfaction and Quality of Life (QoL) after surgery.

MATERIAL AND METHODS: Questionnaires were administered to 24 patients with UC undergoing surgery from 2011 to 2022.

RESULTS: Mean age at IPAA was 10.8 years. Twenty patients underwent IPAA in 3 operations, 4 patients in 2. All patients underwent laparoscopic surgery. 6 months after surgery mean level of satisfaction was 8.7/10, perception of health status was 7.4. Twenty-three patients (95.8%) recommended IPAA. For 20 patients (83.3%) surgery did not cause delay in education, while 14 patients (58.3%) played sport. The lowest number of evacuations was 9.2 per day, the highest 13.3. Seventeen patients (70.8%) had no incontinence and 15 patients (62.5%) were not affected by pouchitis. After 12 months mean satisfaction level raised up to 9.2/10, perception of health status to 8.5. School absences decreased and no other patients showed any delay in education. Seventeen (70.8%) patients played sports. The number of evacuations decreased: the lowest number was 5.1 per day, the highest 7.5. Twenty patients (83.3%) were continent and 12 (50%) did not use antibiotics.

CONCLUSION: Most patients show a good functional outcome in defecation frequency and continence, which has improved through time, number of pouchitis episodes has increased. Patients appear satisfied after surgery.

PMID:39154135 | DOI:10.1007/s00383-024-05824-8

Drug Saf. 2024 Aug 17. doi: 10.1007/s40264-024-01473-x. Online ahead of print.

ABSTRACT

Spontaneous reporting systems (SRS) provide valuable data for detecting unidentified adverse events not observed in clinical trials and for conducting safety assessments that accurately reflect real-world clinical practice. With the increasing number of publications using the SRS for disproportionality analysis (DA), there is an increasing demand for a comprehensive understanding of the research limitations associated with the SRS. However, there is a lack of understanding of the caveats associated with adjusting covariates in DA of the SRS. Herein, we summarized the use of covariate adjustment and its caveats in DA. The Council for International Organizations of Medical Sciences VIII suggests considering adjustments such as stratification when they can enhance the sensitivity and/or specificity of statistical analysis. However, several database-specific and statistical caveats have been identified when adjusting for covariates derived from the SRS. Disproportionality analysis may be affected not only by reporting bias at the time of enrollment but also by sparse-data bias due to variations in the number of enrollment reports. Statistical evidence is needed to determine in which cases and to what extent sensitivity and/or specificity are affected. Nevertheless, it is important for researchers to acknowledge that certain limitations discussed in this context may be inherent and cannot be rectified. Based on this understanding, they can then make an informed decision on whether to perform a covariate adjustment.

PMID:39154117 | DOI:10.1007/s40264-024-01473-x

Biometals. 2024 Aug 17. doi: 10.1007/s10534-024-00624-y. Online ahead of print.

ABSTRACT

The link between exposure to a particular heavy metal or metalloid and the development of anemia is well established. However, the association between combined exposure to multiple heavy metal(loid)s and anemia in children is still lacking in evidence. In this study, a total of 266 children aged 3 to 7 were recruited from Guiyu, China. Inductively coupled plasma mass spectrometry (ICP-MS) was used to measure blood heavy metal(loid) concentrations. Blood cell count, hemoglobin (HGB), mean corpuscular hemoglobin (MCH), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), hematocrit (HCT), and red blood cell distribution width (RDW) were measured by an automated hematology analyzer. Erythrocyte-related parameters were negatively correlated with the Cu and Cu/Zn ratios and positively correlated with Cr, Ni, Zn, and Se by Spearman correlation analysis. Only blood Cu level was negatively correlated with HGB [β = -2.74, (95% Cl: -4.49, -0.995)], MCH [β = -0.505, (95% Cl: -0.785, -0.226)], MCV [β = -1.024, (95% Cl: -1.767, -0.281)], and MCHC [β = -2.137, (95% Cl: -3.54, -0.734)] by multiple linear regression analysis. The Bayesian Kernel Machine Regression (BKMR) model analysis indicated a negative correlation between the combined exposure to Cu, Zn, Pb, and Cr and MCH and MCV. The single-factor analysis showed a considerable statistical difference only with Cu on MCV, MCH, and HGB. Furthermore, the interaction analysis highlighted the interdependent effects of Cu and Zn, Pb and Zn, and Cr and Zn on MCH and MCV levels. Additionally, the oxidation and/or antioxidation reactions may play a significant role in the development of metal(loid)-induced anemia risk. It is crucial to investigate the effects of co-exposure to multiple heavy metal(loid) elements on anemia, especially the interrelationships and mechanisms among them.

PMID:39154116 | DOI:10.1007/s10534-024-00624-y

Sci Rep. 2024 Aug 17;14(1):19081. doi: 10.1038/s41598-024-70224-w.

ABSTRACT

The plant-available soil phosphorus rate and methods for applying phosphatic fertilizer and soil P-fixation capacity are critical factors for lower cotton productivity in Southern Punjab, Pakistan. Hence, a two-year study was conducted in Central Cotton Research Institute (CCRI), Multan, Pakistan, to examine the effects of various P rates and application methods on cotton crop output during the growing seasons of 2014 and 2015. Phosphorus was applied in four rates (0, 40, 80, and 120 kg ha^-1 P₂O₅) using broadcast, band application, and fertigation methods. Results indicated that the impact of P rates was statistically significant on plant height, the number of nodes, monopodial and sympodial branches, leaf area index, harvest index, and seed cotton yield. The greater P application (120 kg P₂O₅ ha^-1) had a better effect on cotton productivity than the lower application rates (0, 40, and 80 kg P₂O₅ ha^-1). The band application responded better on nodes plant^-1, sympodial branches plant^-1, boll weight, leaf area index, lint yield, and harvest during the growing season 2015. Therefore, by adopting the band application coupled with 120 kg P₂O₅ ha^-1 rather than the conventional method of broadcast, productivity of cotton crops could be increased.

PMID:39154113 | DOI:10.1038/s41598-024-70224-w

Arch Dermatol Res. 2024 Aug 17;316(8):533. doi: 10.1007/s00403-024-03334-0.

ABSTRACT

The circulating androgens have a role in the pathogenesis of both acne vulgaris and androgenetic alopecia; an association between these two have been found previously. The aim of this study is to investigate the relationship of the severity of acne vulgaris lesions to the subtype of AGA; and to validate the relationship between severities of acne vulgaris and AGA. This study was conducted cross-sectionally at five different dermatology clinics. Male and female androgenetic alopecia patients with comorbid acne vulgaris have been included. The age, gender, severity of acne lesions, subtype of androgenetic alopecia and the severity of androgenetic alopecia were noted. The severity of acne lesions were graded according to the Global Acne Severity Scale and androgenetic alopecia was graded according to the Hamilton and Ludwig Scales. SPSS v 21 was used for the statistical analysis. A total of 101 patients have been included (12 male and 89 female). The mean age of the patients with severe acne was statistically significantly lower (p = 0.020). The difference in terms of gender was statistically insignificant (p = 0.388). The severity of acne vulgaris was found to be independent of the severity and of the subtype of AGA; p = 0.623 and 0.870 respectively. Neither a relationship between the severity of androgenetic alopecia and severity of acne; nor a relationship between acne severity and androgenetic alopecia subtype were found in this study. Thus we report that, acne severity is independent of the subtype and stage of the co-existing androgenetic alopecia.

PMID:39154095 | DOI:10.1007/s00403-024-03334-0

Pediatr Surg Int. 2024 Aug 17;40(1):230. doi: 10.1007/s00383-024-05820-y.

ABSTRACT

BACKGROUND: Surgical resection remains the cornerstone of treatment for hepatoblastoma in children and offers the best chance of disease-free survival. We aimed to analyze the 30 day outcomes of hepatic resection for hepatoblastoma stratified by extent using the National Surgical Quality Improvement Program-Pediatric (NSQIP-P).

METHODS: We queried NSQIP-P for children undergoing resection of Hepatoblastoma from 2012 to 2021. Relevant clinical characteristics and outcomes were extracted for multivariate logistic regression to identify predictors of common adverse outcomes.

RESULTS: We included 458 children with a median age of 1.90 years. Overall complications were rare, and perioperative blood transfusion (64.2%) and postoperative ventilation > 48 h (10.0%) were the only adverse events prevalent in more than 5% of patients. Median transfusion volume was 15.7 ml/kg. On multivariate regression, only patients undergoing Trisectionectomy (aOR = 3.387, 95% C.I. = 1.348-8.510) had higher odds of receiving > 75th percentile blood transfusion. Furthermore, only perioperative transfusion and postoperative ventilation > 48 h were statistically more common in patients undergoing extended versus standard resections.

CONCLUSIONS: Outcomes following resection of hepatoblastoma are excellent, with low rates of postoperative adverse events. Although children undergoing trisectionectomy likely require greater transfusion volume, extended hepatic resections do not appear to have worse 30 day outcomes despite greater operative complexity and duration.

PMID:39154089 | DOI:10.1007/s00383-024-05820-y

J Neuroinflammation. 2024 Aug 17;21(1):205. doi: 10.1186/s12974-024-03201-9.

ABSTRACT

INTRODUCTION: The Appalachia region of North America is known to have significant health disparities, specifically, worse risk factors and outcomes for stroke. Appalachians are more likely to have comorbidities related to stroke, such as diabetes, obesity, and tobacco use, and are often less likely to have stroke interventions, such as mechanical thrombectomy (MT), for emergent large vessel occlusion (ELVO). As our Comprehensive Stroke Center directly serves stroke subjects from both Appalachian and non-Appalachian areas, inflammatory proteomic biomarkers were identified associated with stroke outcomes specific to subjects residing in Appalachia.

METHODS: There were 81 subjects that met inclusion criteria for this study. These subjects underwent MT for ELVO, and carotid arterial blood samples acquired at time of intervention were sent for proteomic analysis. Samples were processed in accordance with the Blood And Clot Thrombectomy Registry And Collaboration (BACTRAC; clinicaltrials.gov; NCT03153683). Statistical analyses were utilized to examine whether relationships between protein expression and outcomes differed by Appalachian status for functional (NIH Stroke Scale; NIHSS and Modified Rankin Score; mRS), and cognitive outcomes (Montreal Cognitive Assessment; MoCA).

RESULTS: No significant differences were found in demographic data or co-morbidities when comparing Appalachian to non-Appalachian subjects. However, time from stroke onset to treatment (last known normal) was significantly longer and edema volume significantly higher in patients from Appalachia. Further, when comparing Appalachian to non-Appalachian subjects, there were significant unadjusted differences in the NIHSS functional outcome. A comprehensive analysis of 184 proteins from Olink proteomic (92 Cardiometabolic and 92 Inflammation panels) showed that the association between protein expression outcomes significantly differed by Appalachian status for seven proteins for the NIHSS, two proteins for the MoCA, and three for the mRS.

CONCLUSION: Our study utilizes an ELVO tissue bank and registry to investigate the intracranial/intravascular proteomic environment occurring at the time of thrombectomy. We found that patients presenting from Appalachian areas have different levels of proteomic expression at the time of MT when compared to patients presenting from non-Appalachian areas. These proteins differentially relate to stroke outcome and could be used as prognostic biomarkers, or as targets for novel therapies. The identification of a disparate proteomic response in Appalachian patients provides initial insight to the biological basis for health disparity. Nevertheless, further investigations through community-based studies are imperative to elucidate the underlying causes of this differential response.

PMID:39154085 | DOI:10.1186/s12974-024-03201-9

Clin Transl Oncol. 2024 Aug 17. doi: 10.1007/s12094-024-03645-8. Online ahead of print.

ABSTRACT

PURPOSE: This study aimed to develop a tumor radiomics quality and quantity model (RQQM) based on preoperative enhanced CT to predict early recurrence after radical surgery for colorectal liver metastases (CRLM).

METHODS: A retrospective analysis was conducted on 282 cases from 3 centers. Clinical risk factors were examined using univariate and multivariate logistic regression (LR) to construct the clinical model. Radiomics features were extracted using the least absolute shrinkage and selection operator (LASSO) for dimensionality reduction. The LR learning algorithm was employed to construct the radiomics model, RQQM (radiomics-TBS), combined model (radiomics-clinical), clinical risk score (CRS) model and tumor burden score (TBS) model. Inter-model comparisons were made using area under the curve (AUC), decision curve analysis (DCA) and calibration curve. Log-rank tests assessed differences in disease-free survival (DFS) and overall survival (OS).

RESULTS: Clinical features screening identified CRS, KRAS/NRAS/BRAF and liver lobe distribution as risk factors. Radiomics model, RQQM, combined model demonstrated higher AUC values compared to CRS and TBS model in training, internal and external validation cohorts (Delong-test P < 0.05). RQQM outperformed the radiomics model, but was slightly inferior to the combined model. Survival curves revealed statistically significant differences in 1-year DFS and 3-year OS for the RQQM (P < 0.001).

CONCLUSIONS: RQQM integrates both “quality” (radiomics) and “quantity” (TBS). The radiomics model is superior to the TBS model and has a greater impact on patient prognosis. In the absence of clinical data, RQQM, relying solely on imaging data, shows an advantage in predicting early recurrence after radical surgery for CRLM.

PMID:39153176 | DOI:10.1007/s12094-024-03645-8

Plant Foods Hum Nutr. 2024 Aug 17. doi: 10.1007/s11130-024-01220-8. Online ahead of print.

ABSTRACT

Understanding the nutritional diversity in Perilla (Perilla frutescens L.) is essential for selecting and developing superior varieties with enhanced nutritional profiles in the North Eastern Himalayan (NEH) region of India. In this study, we assessed the nutritional composition of 45 diverse perilla germplasm collected from five NEH states using standard protocols and advanced analytical techniques. Significant variability was observed in moisture (0.39-11.67%), ash (2.59-7.13%), oil (28.65-74.20%), protein (11.05-23.15%), total soluble sugars (0.34-3.67%), starch (0.01-0.55%), phenols (0.03-0.87%), ferric reducing antioxidant power (0.45-1.36%), palmitic acid (7.06-10.75%), stearic acid (1.96-2.29%), oleic acid (8.11-13.31%), linoleic acid (15.18-22.74%), and linolenic acid (55.47-67.07%). Similarly, significant variability in mineral content (ppm) was also observed for aluminium, calcium, cobalt, chromium, copper, iron, potassium, magnesium, manganese, molybdenum, sodium, nickel, phosphorus, and zinc. Multivariate analyses, including hierarchical clustering analysis (HCA) and principal component analysis (PCA), revealed the enriched nutritional diversity within the germplasm. Correlation analysis indicated significant positive and negative relationships between nutritional parameters, indicating potential biochemical and metabolic interactions present in the perilla seeds. TOPSIS-based ranking identified promising genotypes for functional foods, pharmaceuticals, and nutritional applications. This study provides a first in-depth report of the nutritional composition and diversity of perilla germplasm in the NEH region, thus aiding in the identification of superior varieties for food and nutritional diversification and security.

PMID:39153163 | DOI:10.1007/s11130-024-01220-8

Plant Foods Hum Nutr. 2024 Aug 17. doi: 10.1007/s11130-024-01227-1. Online ahead of print.

ABSTRACT

The black gram is a traditional pulse crop and is a source of different nutritional components. Due to the scientific community’s preference for yield and its components, the area of nutritional composition remains unexplored. Therefore, the evaluation of various quality traits such as proximate composition, cooking quality, texture profile, and association between them is keen important for the identification of the traits influencing the selection of the genotypes. This research aimed at the evaluation of the 25 black gram genotypes for their proximate composition, the effect of different cooking methods (conventional and microwave) on cooking quality parameters, and texture profile analysis. The genotypes were screened on 17 parameters, mean and replicated value of each variable were subjected to statistical analysis. The results for proximate composition showed the range from 11.2-11.7%, 24.24-28.22%, 1.25-1.85%, 3.10-4.45%, 5.35-6.60%, 60.23-64.86% and 368.35-372.75 Kcal/100 g for moisture, protein, fat, dietary fiber, ash, utilizable carbohydrate, and gross energy respectively. Cooking time ranged from 33 to 55.5 min (traditional) to 29.5-48.5 min (microwave), L: B ratio from 1.35 to 1.85, WUR from 1.85 to 2.60, and GSL from 0.25 to 11.30%. TPA’s cohesiveness, gumminess, and chewiness ranged from 0.19 to 1.44 N, 0.14-1.30 N, 0.58-3.67 N, 1.14-10.81 N, and 0.58-5.29; 1.16-10.50 N in traditional and microwave cooking. Chewiness, gumminess, protein, ash, and cooking time were positively correlated. The first seven PCs have ≥ 1 eigenvalues, accounting for 23.30, 18.00, 13.50, 9.50, 7.40, 6.70%, and 6.40% of total variability. Mandi-2, Kinnour-1, Kirmour-1, Kangra-2, Bilaspur-1, Kangra-3, Kullu-1, Kullu-4, Chamba-3, and Chamba-7 to PCs 1-2 contributed the most to diversity, indicating good selection for subsequent upgrading initiatives.

PMID:39153162 | DOI:10.1007/s11130-024-01227-1