Nevin Manimala

Orthod Craniofac Res. 2023 Aug 11. doi: 10.1111/ocr.12693. Online ahead of print.

ABSTRACT

OBJECTIVE: Mandibular condylar cartilage (MCC) of the rat was examined with the Fourier-transform infrared (FITR) spectroscopic imaging to study the effects of ageing, oestrogen level and altered dietary loading on the structure of MCC.

MATERIALS AND METHODS: The Sprague-Dawley rats (n = 96) aged 5 and 14 months were divided into 12 subgroups according to age, oestrogen status (ovariectomized [OVX], non-ovariectomized [non-OVX)]) and diet (hard, normal, soft). Specimens of the MCC were examined with FTIR spectroscopic imaging to quantify the distribution of collagens and proteoglycans. MCC was divided sagittally into three segments: anterior, most superior and posterior. From each segment, the collagen and proteoglycan contents at different depths of cartilage were statistically compared between the groups using an N-way analysis of variance (ANOVA).

RESULTS: The amount of collagen content was significantly associated with old age in the deep layer of the anterior segment and in the middle layer of the posterior segment of MCC. In the deep layer of the most superior segment, the collagen content also increased with ageing. The amount of proteoglycan content increased significantly when dietary loading increased, and the oestrogen level decreased in the deep layer of the most superior segment of MCC.

CONCLUSION: Ageing, oestrogen level and altered dietary loading have a significant effect on the location and content of collagens and proteoglycans of rat MCC. Ageing significantly increased the amount of collagen content in the superior and posterior segments, being highest in the older soft-diet rats. Decreased oestrogen levels and increased dietary loading increased the amount of proteoglycan content.

PMID:37565299 | DOI:10.1111/ocr.12693

AIDS Res Hum Retroviruses. 2023 Aug 11. doi: 10.1089/AID.2023.0025. Online ahead of print.

ABSTRACT

INTRODUCTION: Adult T-cell leukemia/lymphoma is a malignancy with a poor prognosis caused by HTLV-1 infection. TAX and HBZ are two major viral proteins that may be involved in oncogenesis by disrupting apoptosis. Because Bcl-xL plays an integral role in the anti-apoptotic pathway, this study examines the interaction between host apoptosis and oncoproteins.

METHOD AND MATERIAL: We investigated 37 HTLV-1-infected individuals, including 18 asymptomatic and 19 ATLL subjects. mRNA was extracted and converted to cDNA from peripheral blood mononuclear cells (PBMCs), and then gene expression was determined using TaqMan qPCR. Moreover, the HTLV-I proviral load was also measured using a commercial absolute quantification kit (Novin Gene, Iran).

RESULTS: Data analysis revealed that the mean of TAX, HBZ, and PVL was significantly higher among the study groups (ATLL and carriers groups P= (0.003), P= (0.000), and P= (0.002) respectively). There was no statistical difference in Bcl-xL gene expression between studies groups (P=0.323).

CONCLUSION: It is proposed that this anti-apoptotic pathway may not be directly involved in the development of ATLL lymphoma. TAX, HBZ gene expression, and PVL can be utilized as prognostic markers.

PMID:37565279 | DOI:10.1089/AID.2023.0025

Pediatrics. 2023 Aug 11:e2022058758. doi: 10.1542/peds.2022-058758. Online ahead of print.

ABSTRACT

BACKGROUND: High-flow nasal cannula oxygen therapy (HFNC) is increasingly used to treat bronchiolitis. However, HFNC has not reduced time on supplemental oxygen, length of stay (LOS), or ICU admission. Our objective was to reduce HFNC use in children admitted for bronchiolitis from 41% to 20% over 2 years.

METHODS: Using quality improvement methods, our multidisciplinary team formulated key drivers, including standardization of HFNC use, effective communication, knowledgeable staff, engaged providers and families, data transparency, and high-value care focus. Interventions included: (1) standardized HFNC initiation criteria, (2) staff education, (3) real-time feedback to providers, (4) a script for providers to use with families about expectations during admission, (5) team huddle for patients admitted on HFNC to discuss necessity, and (6) distribution of a bronchiolitis toolkit. We used statistical process control charts to track the percentage of children with bronchiolitis who received HFNC. Data were compared with a comparison institution not actively involved in quality improvement work around HFNC use to ensure improvements were not secondary to the COVID-19 pandemic alone.

RESULTS: Over 10 months of interventions, we saw a decrease in HFNC use for patients admitted with bronchiolitis from 41% to 22%, which was sustained for >12 months. There was no change in HFNC use at the comparison institution. The overall mean LOS for children with bronchiolitis decreased from 60 to 45 hours.

CONCLUSIONS: We successfully reduced HFNC use in children with bronchiolitis, improving delivery of high-value and evidence-based care. This reduction was associated with a 25% decrease in LOS.

PMID:37565278 | DOI:10.1542/peds.2022-058758

Hosp Pediatr. 2023 Aug 11:e2022006730. doi: 10.1542/hpeds.2022-006730. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Penicillin allergy is the most common medication allergy, and the penicillin allergy label is commonly over-applied without adequate reaction history inquiry or documentation. Because penicillin allergy labels are often applied in childhood and carried into adulthood, we sought to increase the completeness of reaction history documentation from 20% to 70% for pediatric hospital medicine patients and from 20% to 50% for all other pediatric inpatients within 12 months. As a secondary outcome, we also aimed to increase the proportion of delabeling unnecessary penicillin labels to 20% for all pediatric inpatients.

METHODS: To address our aims, our quality improvement initiative included education for pediatric faculty and staff, development and implementation of a clinical pathway for allergy risk stratification, and electronic health record optimizations. Statistical process control charts were used to track the impact of the interventions facilitated by an automated dashboard.

RESULTS: Within 12 months of interventions, the completeness of allergy labels improved from 20% to 64% among patients admitted to the pediatric hospital medicine service and improved from 20% to 45% for all other pediatric inpatients. The frequency of penicillin allergy delabeling remained unchanged; however, 98 patients were risk stratified and 34 received outpatient allergy referrals for further testing. The number of adverse drug reactions to penicillin, a balancing measure, did not change during the study period.

CONCLUSIONS: We increased the completeness of penicillin allergy documentation using a standardized workflow facilitated by a multidisciplinary clinical pathway. With ongoing efforts, more penicillin delabeling in low-risk patients is anticipated.

PMID:37565275 | DOI:10.1542/hpeds.2022-006730

Front Pediatr. 2023 Jul 26;11:1135876. doi: 10.3389/fped.2023.1135876. eCollection 2023.

ABSTRACT

BACKGROUND: Untreated maternal postpartum depression (PPD) has consequences for children’s physical growth, but no published study has evaluated changes in this effect over time. Here we therefore aimed to evaluate the dynamic effects of PPD on the physical growth of children in a prospective birth cohort.

METHODS: Between 2015 and 2019, 960 mother-child pairs in Changsha, China were followed up when the child was aged 1-48 months. Data were obtained through household surveys. The mothers’ depressive symptoms were measured using the Edinburgh Postpartum Depression Scale (EPDS) at 1 month postpartum. Linear mixed models were used to examine the changes in the association of PPD and EPDS scores with physical growth in six different age groups of children between 1 and 48 months.

RESULTS: A total of 604 mother-child pairs completed the follow-up, and 3.3% of mothers reported PPD. No associations were found between PPD and weight or height growth at any age. While EPDS scores were associated with weight gain (β = -0.014, 95% CI (-0.025, -0.002), P = 0.024) and height growth (β = -0.044, 95% CI (-0.084, -0.004), P = 0.030) rates at 1-3 months, no associations were found in older children.

LIMITATIONS: The number of mothers who reported PPD was relatively small, and the measurement of PPD was not continuously taken.

CONCLUSIONS: After adjustments for confounders, no dynamic association was found between PPD and children’s weight and height growth. EPDS scores, in contrast, did negatively affect children’s weight and height growth at age 1-3 months, but this effect was not long-lasting.

PMID:37565240 | PMC:PMC10410140 | DOI:10.3389/fped.2023.1135876

Front Pediatr. 2023 Jul 26;11:1212711. doi: 10.3389/fped.2023.1212711. eCollection 2023.

ABSTRACT

BACKGROUND: The 5-year survival rate of childhood cancer exceeds 80%, however, many survivors develop late effects including infertility. The aim of this study was to evaluate the current status of oncofertility care at Vilnius University Hospital Santaros Klinikos (VULSK) within the framework of the EU-Horizon 2020 TREL project.

METHODS: All parents or patients aged 12-17.9 years treated from July 1, 2021 until July 1, 2022 were invited to complete an oncofertility-care-evaluation questionnaire. After completing the questionnaire, patients were triaged to low-risk (LR) or high-risk (HR) of gonadal damage using a risk stratification tool (triage). Data was assessed using descriptive statistics.

RESULTS: Questionnaires were completed by 48 parents and 13 children triaged as 36 (59%) LR and 25 (41%) HR patients. Most HR respondents (21/25, 84%) were not counseled by a fertility specialist. Six boys (4 HR, 2 LR) were counseled, none of the girls was counseled. Three HR boys underwent sperm cryopreservation. Only 17 (27.9%, 9 HR, 8 LR) respondents correctly estimated their risk. All counseled boys (n = 6) agreed the risk for fertility impairment had been mentioned as compared to 49.1% (n = 27) of uncounseled. All counseled respondents agreed they knew enough about fertility (vs. 42%).

CONCLUSIONS: Respondents counseled by a fertility specialist were provided more information on fertility than uncounseled. HR patients were not sufficiently counseled by a fertility specialist. Based on the current experience oncofertility care at VULSK will be improved.

PMID:37565239 | PMC:PMC10411952 | DOI:10.3389/fped.2023.1212711

Bioinform Adv. 2023 Aug 1;3(1):vbad100. doi: 10.1093/bioadv/vbad100. eCollection 2023.

ABSTRACT

MOTIVATION: The International Mouse Phenotyping Consortium (IMPC) is striving to build a comprehensive functional catalog of mammalian protein-coding genes by systematically producing and phenotyping gene-knockout mice for almost every protein-coding gene in the mouse genome and by testing associations between gene loss-of-function and phenotype. To date, the IMPC has identified over 90 000 gene-phenotype associations, but many phenotypes have not yet been measured for each gene, resulting in largely incomplete data; ∼75.6% of association summary statistics are still missing in the latest IMPC summary statistics dataset (IMPC release version 16).

RESULTS: To overcome these challenges, we propose KOMPUTE, a novel method for imputing missing summary statistics in the IMPC dataset. Using conditional distribution properties of multivariate normal, KOMPUTE estimates the association Z-scores of unmeasured phenotypes for a particular gene as a conditional expectation given the Z-scores of measured phenotypes. Our evaluation of the method using simulated and real-world datasets demonstrates its superiority over the singular value decomposition matrix completion method in various scenarios.

AVAILABILITY AND IMPLEMENTATION: An R package for KOMPUTE is publicly available at https://github.com/statsleelab/kompute, along with usage examples and results for different phenotype domains at https://statsleelab.github.io/komputeExamples.

PMID:37565237 | PMC:PMC10409646 | DOI:10.1093/bioadv/vbad100

Tob Control. 2023 Aug 10:tc-2023-057933. doi: 10.1136/tc-2023-057933. Online ahead of print.

ABSTRACT

INTRODUCTION: While previous research has examined misperceptions related to Natural American Spirit (NAS), a premium cigarette brand using ‘natural’-themed marketing, the longitudinal relationship between NAS-related harm beliefs and switching to NAS has not been established.

METHODS: Using data from the PATH study, we modelled the longitudinal relationship between (1) brand switching and subsequent belief that one’s own brand might be less harmful than other brands (Waves 1-5); (2) belief that organic and/or additive-free tobacco products are less harmful and subsequent brand switching (Waves 3-5); and (3) belief that some types of cigarettes are less harmful and subsequent brand switching (Waves 3-5) for NAS and two leading comparator brands (Camel and Marlboro).

RESULTS: Among people who did not think their prior brand might be less harmful, switching to NAS or maintaining NAS preference increased the odds of believing one’s own brand might be less harmful (aOR 19.4; 95% CI: 15.19, 24.8; aOR 6.1; 95% CI: 4.23, 8.67, respectively). Prior belief that organic and additive-free tobacco products were less harmful increased the odds of switching to (aOR 2.5; 95% CI: 1.68, 3.74) and decreased the odds of switching away (0.57; 955 CI: 0.36, 0.92) from NAS in the subsequent wave. Parallel analyses for Marlboro/Camel were largely null or in the opposite direction.

CONCLUSIONS: NAS use may maintain or shape new beliefs that the brand may be less harmful than other brands; holding pre-existing beliefs about the relative harm of some tobacco products may increase risk for NAS use.

PMID:37562949 | DOI:10.1136/tc-2023-057933

Br J Sports Med. 2023 Aug 10:bjsports-2023-106847. doi: 10.1136/bjsports-2023-106847. Online ahead of print.

ABSTRACT

The recognition of myocarditis as a rare side effect of SARS-CoV-2 mRNA vaccination has sparked a global debate on vaccine safety, especially in the realm of sports. The main proposed mechanisms in the pathogenesis of COVID-19 mRNA vaccination-associated myocarditis (C-VAM) are based on the activation of the innate- and adaptive immune system against a susceptible immune-genetic background, including the recognition of mRNA as an antigen by the immune system, molecular mimicry between SARS-CoV-2 spike glycoprotein and cardiac tissue antigens and inflammatory sex-hormone signalling. The relatively younger age of the athlete population hypothetically constellates an increased risk of C-VAM. A subgroup analysis in individuals under 40 years revealed a low incidence of myocarditis following COVID-19 mRNA vaccination when compared to positive SARS-CoV-2 tests. No confirmed cases of athletes experiencing cardiac complications after mRNA vaccination have been reported. Most athletes only reported mild side effects after COVID-19 vaccination. A small but statistically significant decrease in maximal oxygen consumption in recreational athletes occurred after BNT162b2 mRNA booster vaccine administration. The clinical relevance and temporality of which remain to be determined. Many speculative social media reports attribute sudden cardiac arrest/death (SCA/D) in athletes to mRNA vaccination. Large media outlets have thoroughly debunked these claims. There is currently no evidence to support the claim that COVID-19 mRNA vaccination increases the risk of myocardial sequelae or SCA/D in athletes. However, specific vaccine regimen selection and timing may be appropriate to prevent detrimental performance effects.

PMID:37562938 | DOI:10.1136/bjsports-2023-106847

BMJ Open. 2023 Aug 10;13(8):e069818. doi: 10.1136/bmjopen-2022-069818.

ABSTRACT

INTRODUCTION: Subgroups for Targeted Treatment Back Tool (SBT) is a brief multiple-construct risk prediction tool for patients with low back pain (LBP). Thus far, the predictive ability of this tool has been inconsistent. Therefore, we aim to conduct a literature review on the predictive ability of the SBT to determine the outcomes of patients with LBP. The results of this review should improve the ability of the SBT to predict poor outcomes in patients with LBP.

METHODS AND ANALYSIS: Databases including PubMed, EMBASE, Cochrane Central, Web of Science, Chinese National Knowledge Infrastructure Databases, Chinese Science and Technology Journal Database, and Wanfang will be searched for studies on SBT and LBP from their inception until 31 March 2023. Longitudinal studies investigating the association between SBT subgroups and LBP outcomes, including pain, disability and quality of life, will be included. The identified studies will be independently screened for eligibility by two reviewers. A standardised sheet will be used to extract data. The Newcastle-Ottawa Scale will be used to assess the methodological quality of the included studies. Heterogeneity will be evaluated by the χ² test with Cochran’s Q statistic and quantified by the I² statistic. The results will be synthesised qualitatively and presented as pooled risk ratios or beta coefficients quantitatively. The results will also be presented using their 95% confidence limits. Publication bias will be assessed using the method proposed by Egger and by visual inspection of funnel plots.

ETHICS AND DISSEMINATION: This study is a secondary analysis of original studies that received ethics approval. Therefore, prior ethical approval is not required for this study. The findings will be submitted to relevant peer-reviewed journals for publication and presented at profession-specific conferences.

TRIAL REGISTRATION NUMBER: PROSPERO registration numberCRD42022309189.

PMID:37562930 | DOI:10.1136/bmjopen-2022-069818