Nevin Manimala

Neural Netw. 2024 Jul 22;179:106556. doi: 10.1016/j.neunet.2024.106556. Online ahead of print.

ABSTRACT

This paper addresses the asynchronous control problem for semi-Markov reaction-diffusion neural networks (SMRDNNs) under probabilistic event-triggered protocol (PETP) scheduling. A semi-Markov process with a deterministic switching rule is introduced to characterize the stochastic behavior of these networks, effectively mitigating the impacts of arbitrary switching. Leveraging statistical data on communication-induced delays, a novel PETP is proposed that adjusts transmission frequencies through a probabilistic delay division method. The dynamic adjustment of event trigger conditions based on real-time neural network is realized, and the responsiveness of the system is enhanced, which is of great significance for improving the performance and reliability of the communication system. Additionally, a dynamic asynchronous model is introduced that more accurately captures the variations between system modes and controller modes in the network environment. Ultimately, the efficacy and superiority of the developed strategies are validated through a simulation example.

PMID:39068678 | DOI:10.1016/j.neunet.2024.106556

Aging (Albany NY). 2024 Jul 26;16. doi: 10.18632/aging.206033. Online ahead of print.

ABSTRACT

BACKGROUND: Gain of function disturbances in nutrient sensing are likely the largest component in human age-related disease. Mammalian target of rapamycin complex 1 (mTORC1) activity affects health span and longevity. The drugs ketamine and rapamycin are effective against chronic pain and depression, and both affect mTORC1 activity. Our objective was to measure phosphorylated p70S6K, a marker for mTORC1 activity, in individuals with psychiatric disease to determine whether phosphorylated p70S6K could predict medication response.

METHODS: Twenty-seven females provided blood samples in which p70S6K and phosphorylated p70S6K were analyzed. Chart review gathered biometric measurements, clinical phenotypes, and medication response. Questionnaires assessed anxiety, depression, autism traits, and mitochondrial dysfunction, to determine neuropsychiatric disease profiles. Univariate and multivariate statistical analyses were used to identify predictors of medication response.

RESULTS: mTORC1 activity correlated highly with both classical biometrics (height, macrocephaly, pupil distance) and specific neuropsychiatric disease profiles (anxiety and autism). Across all cases, phosphorylated p70S6K was the best predictor for ketamine response, and also the best predictor for rapamycin response in a single instance.

CONCLUSIONS: The data illustrate the importance of mTORC1 activity in both observable body structure and medication response. This report suggests that a simple assay may allow cost-effective prediction of medication response.

PMID:39068671 | DOI:10.18632/aging.206033

Cogn Neuropsychiatry. 2024 Jul 28:1-14. doi: 10.1080/13546805.2024.2364960. Online ahead of print.

ABSTRACT

INTRODUCTION: The study aims to use power spectrum changes in subjective cognitive decline (SCD) and amnestic mild cognitive impairment (aMCI), preclinical stages of Alzheimer’s disease (AD), for future biomarker studies in early AD diagnosis.

METHODS: We recruited 23 SCD and 32 aMCI subjects and conducted comparative analysis using relative power spectral density (PSD). Automated preprocessing and statistical analysis were performed using iSync Brain® (iMediSync Inc., Republic of Korea) (https://isyncbrain.com/).

RESULTS: Theta band power in the temporal region was 14.826 ± 7.2394 for the SCD group and 20.003 ± 10.1768 for the aMCI group. In the parietal region, theta band power was 13.614 ± 7.5689 for SCD and 19.894 ± 11.1387 for aMCI. Beta1 band power in the frontal region was 6.639 ± 2.2904 for SCD and 5.465 ± 1.8907 for aMCI, and in the temporal region it was 7.359 ± 2.5619 for SCD and 5.921 ± 2.1605 for aMCI.

CONCLUSION: PSD analysis of resting-state EEG predicted SCD, a preclinical stage of AD. This cross-sectional study observed electrical-physiological characteristics of preclinical AD; however, follow-up studies are needed to evaluate predictive value for future cognitive decline.

PMID:39068667 | DOI:10.1080/13546805.2024.2364960

Orv Hetil. 2024 Jul 28;165(30):1166-1175. doi: 10.1556/650.2024.33093. Print 2024 Jul 28.

ABSTRACT

Bevezetés: A szív-érrendszeri betegségek világszerte mindkét nem esetében vezető halálokok, köztük a leggyakoribb az ischaemiás szívbetegség. Az egészségügyi információk megszerzési, értelmezési, felhasználási készségeinek gyűjtőfogalma az egészségértés, mely a prevenció több szintjén előre jelezheti az egészségi állapotot, valamint a cardiovascularis mortalitást. Célkitűzés: Kutatásunk célja az egészségértés szintjének és pszichodemográfiai összefüggéseinek vizsgálata volt ischaemiás szívbetegekben. Módszer: Keresztmetszeti, kérdőíves vizsgálatunkban magyar ischaemiás szívbetegek mintáján (n = 78) mértük az egészségértést, emellett az ezzel összefüggő életmódbeli és pszichés jellemzőket. Mérőeszközök: Brief Health Literacy Screening (BHLS), Short Test of Functional Health Literacy for Adults (S-TOFHLA), Heart Disease Knowledge Questionnaire; Rövidített Vitális Kimerültség Kérdőív, Brief Illness Perception Questionnaire, Medication Adherence Report Scale, egészség-magatartás és szubjektív egészségi állapot saját kérdéssorral. Eredmények: Egyik egészségértés teszten sem különbözött szignifikánsan a betegek pontszáma a standard értékektől. Az S-TOFHLA teszten a kitöltők mindössze 6,4%-ának volt nem megfelelő az eredménye, a BHLS tesztnél a 3,8%-uknak. A funkcionális egészségértést az életkor és a vitális kimerültség jelezte előre szignifikánsan (F(72) = 3,94), önállóan csak az utóbbi. A betegségismeret varianciájának 25,7%-át magyarázta az életkort, az iskolai végzettséget és a funkcionális egészségértést tartalmazó regressziós modell (F(74) = 8,18), önállóan az utóbbi kettő jelezte előre. Az önbevallásos egészségértés varianciájának 41,2%-át magyarázta az életkort, az iskolai végzettséget, a vitális kimerültséget, a betegségismeretet és a rizikóviselkedést tartalmazó regressziós modell, amelyben szignifikáns, független előrejelző volt az iskolai végzettség és a vitális kimerültség. A különböző egészségértés-típusok hatását az egészségügyi kimeneti változókra további regressziós modellekkel teszteltük: a betegségreprezentáció varianciájának 29,8%-át magyarázták együttesen (F(3) = 9,321), önálló előrejelzője azonban csak a BHLS teszt volt. Következtetés: Az egészségértés ismert meghatározói mellett rámutattunk a vitális kimerültség szerepére, továbbá az egészségértés és a betegségismeret, valamint a betegségreprezentáció szoros összefüggéseire. A jövőbeli betegedukációk tervezésekor fontosnak tartjuk az egészségértésszint mérését és figyelembevételét. Orv Hetil. 2024; 165(30): 1166–1175.

PMID:39068645 | DOI:10.1556/650.2024.33093

Urolithiasis. 2024 Jul 28;52(1):108. doi: 10.1007/s00240-024-01611-1.

ABSTRACT

Mayo adhesive probability (MAP) score is one of the commonest tool to predict the adherence status of perirenal fat. The association between MAP score and intraoperative hemorrhage in patients undergoing micropercutaneous nephrolithotomy was comfirmed in a recent well designed study. We aimed to investigate if MAP score may predict the possibility for significant intraoperative bleeding in supine percutaneous nephrolithotomy (PCNL) performed with a 26 Fr rigid nephroscope. In this observational retrospective study, demographic, clinical, laboratory, radiological, perioperative (operation duration, hospitalization, intraoperative bleeding, success) and MAP score (perinephric fat stranding, posterior perinephric fat thickness and total MAP score) data of all patients who underwent supine PCNL between June 2021 and July 2023 were evaluated. The patients were divided into 2 groups according to their MAP scores (79 [54.1%] patients with MAP score < 3 [low MAP score] and 67 [54.1%] patients with MAP score ≥ 3 [high MAP score]). The rate of patients with intraoperative bleeding was 47.8% in the patient group with a high MAP score, while it was 22.8% in the patient group with a low MAP score (p = 0.002). In multivariate logistic regression analysis, anticoagulant drug use history (OR = 2.525; 95% CI = 1.025-6.224; p = 0.044), presence of multiple stones (OR = 3.015; 95% CI = 1.205-7.543; p = 0.018), calyx localization of the stone (OR = 2.871;95% CI = 1.166-7.068; p = 0.022), higher renal parenchymal thickness (OR = 1.119; 95% CI = 1.049-1.193; p = 0.001) and MAP score > 3 (OR = 3.486; 95% CI = 1.579-7.696; p = 0.002) were defined as independent risk factors for significant intraoperative bleeding. In clinical practice, the MAP score can be used to predict bleeding before PCNL.

PMID:39068638 | DOI:10.1007/s00240-024-01611-1

MAGMA. 2024 Jul 28. doi: 10.1007/s10334-024-01185-4. Online ahead of print.

ABSTRACT

OBJECT: Diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI) are well-known and powerful imaging techniques for MRI. Although DTI evaluation has evolved continually in recent years, there are still struggles regarding quantitative measurements that can benefit brain areas that are consistently difficult to measure via diffusion-based methods, e.g., gray matter (GM). The present study proposes a new image processing technique based on diffusion distribution evaluation of López-Ruiz, Mancini and Calbet (LMC) complexity called diffusion complexity (DC).

MATERIALS AND METHODS: The OASIS-3 and TractoInferno open-science databases for healthy individuals were used, and all the codes are provided as open-source materials.

RESULTS: The DC map showed relevant signal characterization in brain tissues and structures, achieving contrast-to-noise ratio (CNR) gains of approximately 39% and 93%, respectively, compared to those of the FA and ADC maps.

DISCUSSION: In the special case of GM tissue, the DC map obtains its maximum signal level, showing the possibility of studying cortical and subcortical structures challenging for classical DTI quantitative formalism. The ability to apply the DC technique, which requires the same imaging acquisition for DTI and its potential to provide complementary information to study the brain’s GM structures, can be a rich source of information for further neuroscience research and clinical practice.

PMID:39068635 | DOI:10.1007/s10334-024-01185-4

J Robot Surg. 2024 Jul 28;18(1):298. doi: 10.1007/s11701-024-02007-4.

ABSTRACT

With the development of robotic systems, robotic pancreatoduodenectomies (RPDs) have been increasingly performed. However, the number of cases required by surgeons with extensive laparoscopic pancreatoduodenectomy (LPD) experience to overcome the learning curve of RPD remains unclear. Therefore, we aimed to analyze and explore the impact of different phases of the learning curve of RPD on perioperative outcomes. Clinical data were prospectively collected and retrospectively analyzed for 100 consecutive patients who underwent RPD performed by a single surgeon. This surgeon had previous experience with LPD, having performed 127 LPDs with low morbidity. The learning curve for RPD was analyzed using the cumulative sum (CUSUM) method based on operation time, and perioperative outcomes were compared between the learning and proficiency phases. Between April 2020 and November 2022, one hundred patients (56 men, 44 women) were included in this study. Based on the CUSUM curve of operation time, the learning curve for RPD was divided into two phases: phase I was the learning phase (cases 1-33) and phase II was the proficiency phase (cases 34-100). The operation time during the proficiency phase was significantly shorter than that during the learning phase. In the learning phase of RPD, no significant increases were observed in estimated blood loss, conversion to laparotomy, severe complications, postoperative pancreatic hemorrhage, clinical pancreatic fistula, or other perioperative complications compared to the proficiency phases of either RPD or LPD. A surgeon with extensive prior experience in LPD can safely surmount the RPD learning curve without increasing morbidity in the learning phase. The proficiency was significantly improved after accumulating experience of 33 RPD cases.

PMID:39068626 | DOI:10.1007/s11701-024-02007-4

Arch Orthop Trauma Surg. 2024 Jul 28. doi: 10.1007/s00402-024-05429-9. Online ahead of print.

ABSTRACT

BACKGROUND: Periprosthetic joint infection (PJI) poses a significant challenge in total knee arthroplasty (TKA), with recurrence rates as high as 14-28%, leading to substantial morbidity and treatment costs. When conventional treatments fail, knee fusion and above-the-knee amputation (AKA) emerge as alternative options. Existing literature offers conflicting views on the efficacy and impact of knee fusion versus AKA with varied outcomes and limitations.

METHODS: This retrospective national study spanning 2010-2022 investigates Knee Fusion and AKA as options for addressing Knee PJI. Utilizing PearlDiver Patient Records Database, procedural, and reimbursement data on over 100 million individuals from all the US was evaluated. Readmission rates, costs, and complications of the mentioned procedures were assessed using ICD-9 and ICD-10 codes within a 90-day period and one-year post-operation. Statistical analyses, including chi-square tests and regression models, were conducted using integrated R software.

RESULTS: The study reveals a substantial escalation (p < 0.0001) in the proportion of patients opting for AKA compared to arthrodesis. While age as a demographic factor showed no significant difference, arthrodesis patients exhibited lower comorbidity scores (3.6 ± 2.9 vs. 4.6 ± 3.4, p < 0.001). Arthrodesis correlated with higher 90-day thromboembolism rates (9.2% vs. 7.3%, p < 0.001), blood transfusion requirements (23.2% vs. 14.4%, p < 0.001), and acute renal failure incidence (p = 0.008) but demonstrated lower rates of urinary tract infections (p = 0.047) and cerebrovascular accidents (p < 0.001). At 1 year, arthrodesis was associated with higher infection rates (38.7% vs. 36.4%, p < 0.001). Arthrodesis patients had significant increased 90-day and 1-year readmission rates and hospitalization costs ($12,732 vs. $18,826, p < 0.001).

CONCLUSIONS: We found higher rates of 1-year thromboembolism, infection, acute renal failure, and readmission in the arthrodesis group. AKA patients had more sepsis and cerebrovascular accidents. A patient-centered conversation is best for persistent infections and failed revision TKA. Considering the patient’s quality of life, goals, and health status, this discussion should cover each procedure’s risks and complications.

PMID:39068619 | DOI:10.1007/s00402-024-05429-9

Asian Pac J Cancer Prev. 2024 Jul 1;25(7):2529-2537. doi: 10.31557/APJCP.2024.25.7.2529.

ABSTRACT

BACKGROUND: Despite advances in breast carcinoma therapies, drug resistance mechanisms as anti-apoptosis and anti-pyroptosis limit the application of these therapies. This work assesses the immunohistochemical (IHC) expression of Caspase1 and EGFR in breast carcinoma and analyzes their clinicopathological associations as prognostic markers and potential therapeutic targets. Caspase1/EGFR expression patterns are utilized to specify breast carcinoma patients who may benefit from these therapies.

METHODS: After reviewing the hematoxylin and eosin-stained slides and the routine breast carcinoma IHC stains (estrogen receptors, progesterone receptors, HER2/NEU, Ki-67) by two pathologists and preparation of tissue microarray blocks, anti-Caspase-1 and EGFR IHC staining was performed using Horseradish Peroxidase (HRP) technique. Intensity and percentage-based scoring was applied dividing the 153 included breast carcinomas into Caspase1-negative and positive expression groups; and EGFR low and overexpression groups. Groups were statistically analyzed in relation to age, tumor size, histological and molecular subtype, grade, nodal status, metastasis/recurrence, TNM stage and Ki-67 proliferation index. Kaplan-Meier’s analysis was used to compare disease-free survival (DFS) and overall survival (OS). Combined patterns based on Caspase1 and EGFR expression status were created to stratify patients into prognostic groups.

RESULTS: Caspase1 was positive in 54.2% of breast carcinomas and its positivity was significantly associated with smaller tumor size, absence of metastasis/recurrence, luminal A and B molecular subtypes and longer OS (p<0.05). EGFR overexpression was detected in 32.7% of carcinomas and was significantly associated with larger tumor size, TNBLBC and a shorter OS (p<0.05). Caspase1-negative/EGFR-overexpression pattern comprised 14.4% of carcinomas and had the worst prognostic associations including larger tumor size, metastasis/recurrence, TNBLBC subtype and shortest OS (p=0.002, 0.002, 0.004 and ≤0.001 respectively). Conclusions: Combined Caspase1/EGFR IHC expression may provide a tool for selection of patients who benefit from combined EGFR-inhibitors with miR-155-5p down-regulators or photodynamic therapy via induction of apoptosis/pyroptosis in EGFR-overexpression carcinomas through enhanced Caspase1 signaling.

PMID:39068588 | DOI:10.31557/APJCP.2024.25.7.2529

Asian Pac J Cancer Prev. 2024 Jul 1;25(7):2515-2527. doi: 10.31557/APJCP.2024.25.7.2515.

ABSTRACT

BACKGROUND: Cluster of differentiation 47 (CD47) has been identified as a new immune checkpoint. The exact role of CD47 in prognosis of breast cancer remains unclear. This study aims to evaluate immunohistochemical (IHC) expression of CD47 in breast cancer, and to measure the density of tumor associated macrophages (TAMs) infiltration by CD68 IHC staining. Furthermore, assessing the relations of CD47 and CD68 expression to different clinicopathological variables and evaluating the prognostic role of CD47 and CD68 in breast cancer cases.

METHODS: This retrospective cohort study included 200 diagnosed primary breast cancer cases who underwent surgical resection at the Oncology Center of Mansoura University (OCMU), Faculty of Medicine, Egypt. Clinicopathological and survival data were collected. IHC for CD47 and CD68 was performed.

RESULTS: Among 200 breast cancer cases, high CD47 expression was detected in 89 cases (44.5%). CD47 high expression was significantly associated with presence of distant metastasis (P=0.04), advanced TNM stage (P=0.02), ER & PR negativity (P=0.04 & 0.004 respectively), and molecular subtype (P=0.03). Their was a statistically significant association between CD47 and CD68 expression (P=0.002). CD47 high expression was found to predict poor overall survival, but it is not considered alone as independent poor prognostic factor by multivariate analysis. Multivariate analysis spotted combined high expression of CD47 and CD68 as an independent prognostic predictor for shorter OS in breast cancer patients (P=0.002).

CONCLUSION: CD47 high expression is related to poor prognosis in breast cancer patients especially when associated with high CD68+TAMs infiltration. Therefore, CD47 is a promising prognostic and therapeutic target in breast carcinoma that may direct selection of patients for immunotherapy.

PMID:39068587 | DOI:10.31557/APJCP.2024.25.7.2515