Nevin Manimala

J Am Heart Assoc. 2024 Jun 7:e033320. doi: 10.1161/JAHA.123.033320. Online ahead of print.

ABSTRACT

BACKGROUND: Olfactory impairment is common in older adults and may be associated with adverse cardiovascular health; however, empirical evidence is sparse. We examined olfaction in relation to the risk of coronary heart disease (CHD), stroke, and congestive heart failure (CHF).

METHODS AND RESULTS: This study included 2537 older adults (aged 75.6±2.8 years) from the Health ABC (Health, Aging, and Body Composition) study with olfaction assessed by the 12-item Brief Smell Identification Test in 1999 to 2000, defined as poor (score ≤8), moderate (9-10), or good (11-12). The outcomes were incident CHD, stroke, and CHF. During up to a 12-year follow-up, 353 incident CHD, 258 stroke, and 477 CHF events were identified. Olfaction was statistically significantly associated with incident CHF, but not with CHD or stroke. After adjusting for demographics, risk factors, and biomarkers of CHF, the cause-specific hazard ratio (HR) of CHF was 1.32 (95% CI, 1.05-1.66) for moderate and 1.28 (95% CI, 1.01-1.64) for poor olfaction. These associations were robust in preplanned subgroup analyses by age, sex, race, and prevalent CHD/stroke. While the subgroup results were not statistically significantly different, the association of olfaction with CHF appeared to be evident among participants who reported very good to excellent health (HR, 1.47 [95% CI, 1.01-2.14] for moderate; and 1.76 [95% CI, 1.20-2.58] for poor olfaction), but not among those with fair to poor self-reported health (HR, 1.04 [95% CI, 0.64-1.70] for moderate; and 0.92 [95% CI, 0.58-1.47] for poor olfaction).

CONCLUSIONS: In community-dwelling older adults, a single olfaction test was associated with a long-term risk for incident CHF, particularly among those reporting very good to excellent health.

PMID:38847146 | DOI:10.1161/JAHA.123.033320

J Biophotonics. 2024 Jun 7:e202300566. doi: 10.1002/jbio.202300566. Online ahead of print.

ABSTRACT

Identification and classification of pathogenic bacterial strains is of current interest for the early treatment of diseases. In this work, protein fluorescence from eight different pathogenic bacterial strains were characterized using steady state and time resolved fluorescence spectroscopy. The spectral deconvolution method was also employed to decompose the emission contribution from different intrinsic fluorophores and extracted various key parameters, such as intensity, emission maxima, emission line width of the fluorophores, and optical redox ratio. The change in average lifetime values across different bacterial strains exhibits good statistical significance (p ≤ 0.01). The variations in the photophysical characteristics of bacterial strains are due to the different conformational states of the proteins. The stepwise multiple linear discriminate analysis of fluorescence emission spectra at 280 nm excitation across eight different bacterial strains classifies the original groups and cross validated group with 100% and 99.5% accuracy, respectively.

PMID:38847123 | DOI:10.1002/jbio.202300566

ANZ J Surg. 2024 Jun 7. doi: 10.1111/ans.19116. Online ahead of print.

ABSTRACT

BACKGROUND: Haemorrhoidectomy is the gold standard for definitive treatment of high-grade symptomatic haemorrhoids but is often associated with substantial pain. This systematic review aims to explore the potential of flavonoids in alleviating the postoperative symptom burden following excisional haemorrhoidectomy.

METHODS: A systematic review of the literature was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO CRD42023472711). Randomized controlled trials (RCTs) published PubMed, MEDLINE, Embase, and Scopus from inception to 1st December 2023 were retrieved. The primary outcome investigated was post-operative pain. Meta-analysis was performed using Review Manager version 5.4.1.

RESULTS: Ten articles with 775 patients were included. The meta-analysis identified statistically significant decreases in post-operative pain in favour of the flavonoid groups (Standardized Mean Difference -0.66 [95% confidence intervals (CI) -0.82, -0.52]; P < 0.00001), and bleeding (Odds Ratio 0.13 [95% CI 0.09, 0.19]; P < 0.00001).

CONCLUSION: Flavonoids show promise as a means of reducing pain associated with excisional haemorrhoidectomy. Further research is required to investigate topical routes of administration and standardize regimes.

PMID:38847122 | DOI:10.1111/ans.19116

Euro Surveill. 2024 Jun;29(23). doi: 10.2807/1560-7917.ES.2024.29.23.2400301.

ABSTRACT

Since January 2024, Italy experiences a pertussis outbreak, primarily affecting neonates and unvaccinated infants at high risk of severe complications and mortality; 11 major paediatric centres noted 108 hospitalisations and three deaths by 10 May. The outbreak reflects increased circulation of Bordetella pertussis and non-adherence to immunisation recommendations during pregnancy. Public health interventions, including maternal immunisation, vaccination of infants as early as possible and post-exposure prophylaxis, are critical for reducing the burden of pertussis and preventing further mortality.

PMID:38847118 | DOI:10.2807/1560-7917.ES.2024.29.23.2400301

Ann Surg. 2024 Jun 7. doi: 10.1097/SLA.0000000000006370. Online ahead of print.

ABSTRACT

OBJECTIVE: To systematically review technologies that objectively measure CWL in surgery, assessing their psychometric and methodological characteristics.

SUMMARY BACKGROUND DATA: Surgical tasks involving concurrent clinical decision-making and the safe application of technical and non-technical skills require a substantial cognitive demand and resource utilization. Cognitive overload leads to impaired clinical decision-making and performance decline. Assessing cognitive workload (CWL) could enable interventions to alleviate burden and improve patient safety.

METHODS: Ovid MEDLINE, OVID Embase, the Cochrane Library and IEEE Xplore databases were searched from inception to August 2023. Full-text, peer-reviewed original studies in a population of surgeons, anesthesiologists or interventional radiologists were considered, with no publication date constraints. Study population, task paradigm, stressor, Cognitive Load Theory (CLT) domain, objective and subjective parameters, statistical analysis and results were extracted. Studies were assessed for a) definition of CWL, b) details of the clinical task paradigm, and c) objective CWL assessment tool. Assessment tools were evaluated using psychometric and methodological characteristics.

RESULTS: 10790 studies were identified; 9004 were screened; 269 full studies were assessed for eligibility, of which 67 met inclusion criteria. The most widely used assessment modalities were autonomic (32 eye studies and 24 cardiac). Intrinsic workload (e.g. task complexity) and germane workload (effect of training or expertize) were the most prevalent designs investigated. CWL was not defined in 30 of 67 studies (44.8%). Sensitivity was greatest for neurophysiological instruments (100% EEG, 80% fNIRS); and across modalities accuracy increased with multi-sensor recordings. Specificity was limited to cardiac and ocular metrics, and was found to be sub-optimal (50% and 66.67%). Cardiac sensors were the least intrusive, with 54.2% of studies conducted in naturalistic clinical environments (higher ecological validity).

CONCLUSION: Physiological metrics provide an accessible, objective assessment of CWL, but dependence on autonomic function negates selectivity and diagnosticity. Neurophysiological measures demonstrate favorable sensitivity, directly measuring brain activation as a correlate of cognitive state. Lacking an objective gold standard at present, we recommend the concurrent use of multimodal objective sensors and subjective tools for cross-validation. A theoretical and technical framework for objective assessment of CWL is required to overcome the heterogeneity of methodological reporting, data processing, and analysis.

PMID:38847099 | DOI:10.1097/SLA.0000000000006370

Eur Endod J. 2024 Jun 6. doi: 10.14744/eej.2024.32559. Online ahead of print.

ABSTRACT

OBJECTIVE: Syringe irrigation, commonly used for delivering sodium hypochlorite (NaOCl) during root canal treatment, requires careful handling to prevent NaOCl extrusion into periapical tissues. This randomized controlled in vitro study aimed to quantify syringe plunger forces exerted by dental undergraduates and to assess the impact of an educational intervention on adherence to safe irrigant delivery parameters.

METHODS: Fifty-two undergraduates performed syringe irrigation at three intervals: baseline (T1), after two weeks (T2), and after 12 weeks (T3). At T1, irrigation was conducted without prior educational intervention, while at T2, it was preceded by an intervention. The educational intervention involved a short video highlighting safe irrigation practices, including plunger force and time recommendations for syringe irrigation. At T3, the undergraduates were randomly allocated to two groups: One received a repeated intervention, while the other did not. Syringe irrigation was performed on a 3D-printed tooth using two side-vented cannulas: one of 25 Gauge (G) and another of 30 G. A syringe equipped with a force sensor recorded the plunger forces. Based on earlier research, plunger forces exceeding 10 Newtons (N) for the 25 G cannula and 40 N for the 30 G cannula were deemed critical. The data were subjected to descriptive statistical analyses.

RESULTS: Overall, the mean of maximum values of plunger forces remained under 10 N for the 25 G and below 20 N for the 30 G cannulas, with only few measurements exceeding 40 N. Instances of surpassing the critical plunger force threshold were more common with the 25 G side-vented cannula than with the 30 G variant. At T3, the group that received the repeated educational intervention exhibited lower average maximum plunger forces for both types of cannulas compared with the group that did not receive the intervention.

CONCLUSION: Integrating plunger force measurements with targeted educational interventions presents an effective approach for instructing undergraduates in the proper techniques of syringe irrigation. The findings suggest that, generally, undergraduates do not apply excessive plunger forces that could risk apical irrigant extrusion. The implementation of repeated educational interventions has been shown to decrease the plunger forces exerted by undergraduates, underscoring its effectiveness in fostering safe endodontic irrigation.

PMID:38847052 | DOI:10.14744/eej.2024.32559

Fa Yi Xue Za Zhi. 2024 Apr 25;40(2):149-153. doi: 10.12116/j.issn.1004-5619.2023.231206.

ABSTRACT

OBJECTIVES: To investigate the age-related changes of the mandibular third molar root pulp visibility in individuals in East China, and to explore the feasibility of applying this method to determine whether an individual is 18 years or older.

METHODS: A total of 1 280 oral panoramic images were collected from the 15-30 years old East China population, and the mandibular third molar root pulp visibility in all oral panoramic images was evaluated using OLZE 0-3 four-stage method, and the age distribution of the samples at each stage was analyzed using descriptive statistics.

RESULTS: Stages 0, 1, 2 and 3 first appeared in 16.88, 19.18, 21.91 and 25.44 years for males and in 17.47, 20.91, 22.01 and 26.01 years for females. In all samples, individuals at stages 1 to 3 were over 18 years old.

CONCLUSIONS: It is feasible to determine whether an individual in East China is 18 years or older based on the mandibular third molar root pulp visibility on oral panoramic images.

PMID:38847029 | DOI:10.12116/j.issn.1004-5619.2023.231206

Fa Yi Xue Za Zhi. 2024 Apr 25;40(2):118-127. doi: 10.12116/j.issn.1004-5619.2023.231103.

ABSTRACT

In the study of age estimation in living individuals, a lot of data needs to be analyzed by mathematical statistics, and reasonable medical statistical methods play an important role in data design and analysis. The selection of accurate and appropriate statistical methods is one of the key factors affecting the quality of research results. This paper reviews the principles and applicable principles of the commonly used medical statistical methods such as descriptive statistics, difference analysis, consistency test and multivariate statistical analysis, as well as machine learning methods such as shallow learning and deep learning in the age estimation research of living individuals, and summarizes the relevance and application prospects between medical statistical methods and machine learning methods. This paper aims to provide technical guidance for the age estimation research of living individuals to obtain more scientific and accurate results.

PMID:38847025 | DOI:10.12116/j.issn.1004-5619.2023.231103

Endosc Int Open. 2024 Jun 6;12(6):E732-E739. doi: 10.1055/a-2306-6535. eCollection 2024 Jun.

ABSTRACT

Background and study aims Endoscopic resection has traditionally involved electrosurgical cautery (hot snare) to resect premalignant polyps. Recent data have suggested superior safety of cold resection. We aimed to assess the safety of cold compared with traditional (hot) resection for non-ampullary duodenal polyps. Methods We performed a systematic review ending in September 2022. The primary outcome of interest was the adverse event (AE) rate for cold compared with hot polyp resection. We reported odds ratios with 95% confidence intervals (CIs). Secondary outcomes included rates of polyp recurrence and post-polypectomy syndrome. We assessed publication bias with the classic fail-safe test and used forest plots to report pooled effect estimates. We assessed heterogeneity using I ₂ index. Results Our systematic review identified 1,215 unique citations. Eight of these met inclusion criteria, seven of which were published manuscripts and one of which was a recent meeting abstract. On random effect modeling, cold resection was associated with significantly lower odds of delayed bleeding compared with hot resection. The difference in the odds of perforation (odds ratio [OR] 0.31 [95% confidence interval [CI] 0.05-2.87], P =0.2, I ₂ =0) and polyp recurrence (OR 0.75 [95% CI 0.15-3.73], P =0.72, I ₂ =0) between hot and cold resection was not statistically significant. There were no cases of post-polypectomy syndrome reported with either hot or cold techniques. Conclusions Cold resection is associated with lower odds of delayed bleeding compared with hot resection for duodenal tumors. There was a trend toward higher odds of perforation and recurrence following hot resection, but this trend was not statistically significant.

PMID:38847013 | PMC:PMC11156513 | DOI:10.1055/a-2306-6535

Gastroenterol Rep (Oxf). 2024 Jun 5;12:goae057. doi: 10.1093/gastro/goae057. eCollection 2024.

ABSTRACT

BACKGROUND: Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide and is prevalent in East Asia. Although genome-wide association studies (GWASs) of HCC have identified 23 risk regions, the susceptibility genes underlying these associations largely remain unclear. To identify novel candidate genes for HCC, we conducted liver single-tissue and cross-tissue transcriptome-wide association studies (TWASs) in two populations of East Asia.

METHODS: GWAS summary statistics of 2,514 subjects (1,161 HCC cases and 1,353 controls) from the Chinese Qidong cohort and 161,323 subjects (2,122 HCC cases and 159,201 controls) from the BioBank Japan project were used to conduct TWAS analysis. The single-tissue and cross-tissue TWAS approaches were both used to detect the association between susceptible genes and the risk of HCC. TWAS identified genes were further annotated by Metascape, UALCAN, GEPIA2, and DepMap.

RESULTS: We identified 22 novel genes at 16 independent loci significantly associated with HCC risk after Bonferroni correction. Of these, 13 genes were located in novel regions. Besides, we found 83 genes overlapped in the Chinese and Japanese cohorts with P < 0.05, of which, three genes (NUAK2, HLA-DQA1, and ATP6V1G2) were discerned by both single-tissue and cross-tissue TWAS approaches. Among the genes identified through TWAS, a significant proportion of them exhibit a credible role in HCC biology, such as FAM96B, HSPA5, POLRMT, MPHOSPH10, and RABL2A. HLA-DQA1, NUAK2, and HSPA5 associated with the process of carcinogenesis in HCC as previously reported.

CONCLUSIONS: Our findings highlight the value of leveraging the gene expression data to identify new candidate genes beyond the GWAS associations and could further provide a genetic insight for the biology of HCC.

PMID:38846986 | PMC:PMC11153834 | DOI:10.1093/gastro/goae057