Nevin Manimala

Acta Paediatr. 2024 Oct 24. doi: 10.1111/apa.17475. Online ahead of print.

ABSTRACT

AIM: The purpose of this study was to evaluate irisin, myonectin and high-sensitivity interleukin-6 (hs IL-6) levels in obese children and adolescents and to determine the association of these parameters with metabolic dysfunction-associated steatotic liver disease (MASLD) in children.

METHODS: Sixty-one overweight/obese children with suspected liver disease and seventeen healthy controls were included in the study. MASLD was diagnosed according to the latest consensus. Circulating irisin, myonectin and hs IL-6 were measured by enzyme-linked immunosorbent assay (ELISA).

RESULTS: The study group included 38 children meeting MASLD criteria and 23 children without diagnosed hepatic steatosis. The concentrations of the analysed myokines were comparable in the MASLD and non-MASLD groups. Patients with MASLD were further divided according to the severity of hepatic steatosis. Significantly higher levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyltransferase, uric acid and irisin were observed in patients with severe hepatic steatosis compared to mild hepatic steatosis. There were borderline statistically significant positive correlations of irisin with ALT and AST.

CONCLUSION: We revealed that elevated irisin levels were associated with the degree of hepatic steatosis in MASLD. We also found a borderline significant positive association of irisin with liver enzymes.

PMID:39448554 | DOI:10.1111/apa.17475

J Exp Anal Behav. 2024 Oct 24. doi: 10.1002/jeab.4222. Online ahead of print.

ABSTRACT

One of the most common treatments for severe challenging behavior involves placing the challenging behavior on extinction and differentially reinforcing an alternative response (DRA). However, extinction is not always feasible and may be unsafe or impractical to implement in some circumstances. Thus, implementing a DRA without extinction intervention may be necessary for some cases. Currently, the extent to which DRA without extinction produces durable treatment outcomes, particularly as it relates to the resurgence of challenging behavior, is unclear. The present study investigated resurgence following DRA with and without extinction using a three-phase resurgence evaluation in a translational human operant model with college students as participants. All participants demonstrated resurgence across both experimental groups. Although there were no statistically significant differences in the prevalence, magnitude, or persistence of resurgence between groups, levels of resurgence magnitude were relatively higher in the DRA-without-extinction group than in the DRA-with-extinction group. Clinical implications of these findings and directions for future human operant investigations of resurgence are discussed.

PMID:39448553 | DOI:10.1002/jeab.4222

Natl Med J India. 2024 Jul-Aug;37(4):181-190. doi: 10.25259/NMJI_241_2023.

ABSTRACT

Background About 35% of the global child deaths and 11% of the total disease burden are due to inadequate nutrition. While in India, 1 in 3 children are underweight and stunted, and 1 in 5 children are wasted. Methods Using multivariate and descriptive statistical analysis, we examined the prevalence, determinants of minimum diet diversity failure (MDDF) and trends of MDDF across different regions of India among children aged 6-23 months. Dietary pattern in 8 food groups was also examined using the National Family and Health Survey (NFHS) data from 2005-06 to 2019-21. Results Overall, MDDF in India has decreased from 87.4% (2005-06) to 77.1% (2019-21). The central region (84.6%) reported the highest prevalence of MDDF in 2019-21. Children of illiterate and rural residing mothers with no mass media exposure, children of the first birth order and children not exposed to counselling and health check-ups at Anganwadi/Integrated Child Development Services (ICDS) centres, children with low birth weight and anaemic, and who belonged to a large family had greater likelihood for MDDF. Conclusion To tackle the high prevalence of MDDF, a holistic action is needed from the government, i.e. improved public distribution system (PDS), intensified Integrated Child Development Scheme (ICDS) programme, use of social media, and nutrition counselling through local self-governance.

PMID:39448534 | DOI:10.25259/NMJI_241_2023

Natl Med J India. 2024 Jul-Aug;37(4):209-214. doi: 10.25259/NMJI_852_2022.

ABSTRACT

Background The challenge faced by an undergraduate medical student to draw factually correct histology diagrams needs to be addressed by the use of innovative teaching strategies. We introduced a new method to teach drawing of histology diagrams and compared its outcome with two preexisting methods. We obtained feedback from the students and faculty. Methods We introduced an innovation (method 3): A validated hand-drawn pencil sketch of a histology diagram was provided to the students. Students drew on the pencil sketch with haematoxylin and eosin (H&E) pencils and coloured it. They then drew the same diagram afresh. Three diagrams of systemic histology were chosen and the evaluation criteria shared with students. The students drew all three diagrams once, each by a different method. The scores of method 3 were compared with the other two methods, copying from standard atlas (method 1) and from hand-drawn colour chart made by teacher (method 2). Feedback was sought from students and faculty by means of a google form. Results A total of 112 students (of 167 who volunteered) completed the study. The mean (SD) score obtained by method 3 (4.83 [0.298]) was higher than the mean score by method 1 (3.91 [0.95]) and method 2 (4.82 [0.27]). There was a statistically significant difference between method 3 and method 1 (p<0.01), and method 2 and method 1 (p<0.01). However, the difference in scores between methods 3 and 2 was not statistically significant (p>0.05). Conclusion We found method 3 (the innovation) to be better than one of the pre-existing methods (method 1) but not better than method 2. The quality of diagrams produced by methods 2 and 3 were better than those by method 1, and equally so. The ease of drawing and time taken to draw were the best for method 2. Hence, overall, method 2 may be adjudged the best method.

PMID:39448530 | DOI:10.25259/NMJI_852_2022

Psychon Bull Rev. 2024 Oct 24. doi: 10.3758/s13423-024-02601-5. Online ahead of print.

ABSTRACT

Recent developments in artificial intelligence (AI) have led to changes in healthcare. Government and regulatory bodies have advocated the need for transparency in AI systems with recommendations to provide users with more details about AI accuracy and how AI systems work. However, increased transparency could lead to negative outcomes if humans become overreliant on the technology. This study investigated how changes in AI transparency affected human decision-making in a medical-screening visual search task. Transparency was manipulated by either giving or withholding knowledge about the accuracy of an ‘AI system’. We tested performance in seven simulated lab mammography tasks, in which observers searched for a cancer which could be correctly or incorrectly flagged by computer-aided detection (CAD) ‘AI prompts’. Across tasks, the CAD systems varied in accuracy. In the ‘transparent’ condition, participants were told the accuracy of the CAD system, in the ‘not transparent’ condition, they were not. The results showed that increasing CAD transparency impaired task performance, producing an increase in false alarms, decreased sensitivity, an increase in recall rate, and a decrease in positive predictive value. Along with increasing investment in AI, this research shows that it is important to investigate how transparency of AI systems affect human decision-making. Increased transparency may lead to overtrust in AI systems, which can impact clinical outcomes.

PMID:39448515 | DOI:10.3758/s13423-024-02601-5

Planta. 2024 Oct 24;260(6):125. doi: 10.1007/s00425-024-04548-2.

ABSTRACT

In the present review, we discussed the detailed signaling cascades via membrane transporters that confer plant tolerance to abiotic stresses and possible significant use in plant development for climate-resilient crops. Plant transporters play significant roles in nutrient uptake, cellular balance, and stress responses. They facilitate the exchange of chemicals and signals across the plant’s membrane by signal transduction, osmotic adjustment, and ion homeostasis. Therefore, research into plant transporters is crucial for understanding the mechanics of plant stress tolerance. Transporters have potential applications in crop breeding for increased stress resistance. We discuss new results about various transporter families (ABC, MATE, NRAMP, NRT, PHT, ZIP), including their functions in abiotic stress tolerance and plant development. Furthermore, we emphasize the importance of transporters in plant responses to abiotic stresses such as drought, cold, salt, and heavy metal toxicity, low light, flooding, and nutrient deficiencies. We discuss the transporter pathways and processes involved in diverse plant stress responses. This review discusses recent advances in the role of membrane transporters in abiotic stress tolerance in Arabidopsis and other crops. The review contains the genes discovered in recent years and associated molecular mechanisms that improve plants’ ability to survive abiotic stress and their possible future applications by integrating membrane transporters with other technologies.

PMID:39448443 | DOI:10.1007/s00425-024-04548-2

J Math Biol. 2024 Oct 24;89(5):54. doi: 10.1007/s00285-024-02153-1.

ABSTRACT

This paper is concerned with spatiotemporal dynamics of a fractional diffusive susceptible-infected-susceptible (SIS) epidemic model with mass action infection mechanism. Concretely, we first focus on the existence and stability of the disease-free and endemic equilibria. Then, we give the asymptotic profiles of the endemic equilibrium on small and large diffusion rates, which can reveal the impact of dispersal rates and fractional powers simultaneously. It is worth noting that we have some counter-intuitive findings: controlling the flow of infected individuals will not eradicate the disease, but restricting the movement of susceptible individuals will make the disease disappear.

PMID:39448396 | DOI:10.1007/s00285-024-02153-1

Pediatr Surg Int. 2024 Oct 24;40(1):273. doi: 10.1007/s00383-024-05864-0.

ABSTRACT

BACKGROUND: Congenital heart disease (CHD) care has evolved during the past decades. Advances in care have contributed to improved survival among CHD patients. Children with CHD are requiring interventions for non-CHD related medical issues that occur in the general pediatric population.

METHODS: A retrospective review of the Pediatric Health Information System (PHIS) database from January 1, 2004, to July 31, 2023. Discharges of patients with an admitting/principal diagnosis of appendicitis were evaluated and categorized as CHD or non-CHD.

RESULTS: A total of 319,228 patients were identified with 1,25,858(39.4%) female, 1,38,966(43.5%) white, and median age of 11[IQR:8-14] years. 708(0.2%) had CHD with 85(12%) of them having a diagnosis consistent with single-ventricle CHD (SV-CHD). In univariate analysis, CHD patients were more likely to undergo conservative treatment (n = 172(24.2%)vs n = 59,358(18.6%)) and less likely to undergo laparoscopic appendectomy (n = 483(68.2%) vs n = 2,35,324(73.8%))(p < 0.001) compared to non-CHD. After adjustment, CHD patients had increased odds of undergoing open appendectomy compared to non-CHD. CHD patients were more likely to have an ICU admission (OR:8.36(95%CI 6.35-10.00),p < 0.001) and had a 77.6%(95%CI 40.89-123.93) increase in length of stay (LOS) (p < 0.001).

CONCLUSION: CHD patients are more likely to have an open appendectomy than non-CHD patients. These findings suggest a distinctive pattern in the care of CHD patients compared to non-CHD. Overall, CHD patients had a more intense level of care with longer LOS and increased ICU admissions. Further work is needed to evaluate drivers of management decisions, the role of conservative treatment with antibiotics alone in the CHD population, and the potential impacts and safety of a laparoscopic approach.

PMID:39448395 | DOI:10.1007/s00383-024-05864-0

BJU Int. 2024 Oct 24. doi: 10.1111/bju.16539. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the relationship between renal pelvis pressure and infection after ureteroscopy, using a live swine model.

MATERIALS AND METHODS: In anaesthetised pigs, a 1-h ureteroscopy was performed using a pressure-sensing guidewire, with renal pelvis pressure maintained at either 37 mmHg or 75 mmHg for the entire procedure and infusion with saline alone or with a standardised concentration of uropathogenic Escherichia coli strain CFT073 (1.5 × 10⁷ colony-forming units [CFU]/mL). Venous blood sampling was performed during and after the procedure. Vital signs, inflammatory biomarkers, and renal tissue and blood cultures were assessed.

RESULTS: In 21 pig kidneys, study groups were: 37 mmHg with saline irrigation (n = 3); 75 mmHg with saline irrigation (n = 4); 37 mmHg with saline irrigation with 1.5 × 10⁷ CFU/mL E. coli (n = 7); and 75 mmHg with saline irrigation with 1.5 × 10⁷ CFU/mL E. coli (n = 7). Statistically significant changes in inflammatory biomarkers were most pronounced in the group with 75 mmHg saline irrigation + E. coli and were significantly elevated compared with the control group and the group receiving E. coli irrigation at 37 mmHg. Positive blood cultures were noted in 5/7 animals treated with E. coli at 75 mmHg; no others developed bacteraemia.

CONCLUSION: In this swine model of ureteroscopy, irrigation with saline + E. coli at a renal pelvis pressure of 75 mmHg resulted in bacteraemia and inflammatory biomarker elevations significantly greater than both E. coli irrigation with renal pelvis pressure maintained at 37 mmHg and the control.

PMID:39448382 | DOI:10.1111/bju.16539

J World Fed Orthod. 2024 Oct 23:S2212-4438(24)00083-3. doi: 10.1016/j.ejwf.2024.09.009. Online ahead of print.

ABSTRACT

BACKGROUND: This study used cone-beam computed tomography (CBCT) via voxel-based superimposition to evaluate lip and incisor changes after orthodontic treatment with four premolar extractions (Ext) versus nonextraction (Non-Ext) among African American (AA) and White (W) patients.

METHODS: A total of 240 CBCTs of 120 adolescent orthodontic patients with Class I skeletal/dental relationships were included. Patients were initially divided according to treatment, and then each group was subdivided according to patients’ ethnicity (Ext/W = 30, Ext/AA = 30, Non-Ext/W = 30, and Non-Ext/AA = 30). CBCTs were imported into Invivo6 for voxel-based superimposition. Lip and incisor measurements were recorded. Independent t tests and two-way ANOVA were used for statistical assessment.

RESULTS: The Non-Ext/W group had a greater increase in all outcome variables compared with the Non-Ext/AA group, with a significant change in volume and position of upper (UL) and lower lips (LL), inclination of upper (U1) and lower incisors (L1), and position of U1. The Ext/AA group had a greater decrease in all measured outcomes compared with the Ext/W group, with significant change in inclination of U1 and L1, and position and volume of LL. W patients had more crowding than AA patients in both treatment approaches. Retraction ratios of 6.5:1 and 2.1:1 were recorded between the U1 and UL positions, and L1 and LL positions, respectively. There were no direct interaction effects between ethnicity and treatment, nor were there any significant effects of ethnicity after controlling for the covariates.

CONCLUSIONS: Ethnicity alone has no impact on incisor and lip position after treatment. However, ethnicity in the form of initial presentation of malocclusion can have a significant influence.

PMID:39448364 | DOI:10.1016/j.ejwf.2024.09.009