Nevin Manimala

Cannabis Cannabinoid Res. 2023 Oct 19. doi: 10.1089/can.2023.0119. Online ahead of print.

ABSTRACT

Purpose: Given increased cannabis use for medical and nonmedical purposes alike, there is growing public interest related to the potential risks and benefits of cannabis use, particularly related to cancer. The purpose of this descriptive study was to analyze cannabis inquiries to the National Cancer Institute’s Cancer Information Service (CIS). Materials and Methods: From September 2018 to June 2023, 190,070 noncannabis and 425 cannabis inquiries were documented by the CIS. Cannabis inquiries were delineated into two categories: nonmedical cannabis (NMC, n=240) or medical cannabis (MC, n=185). Chi-square tests were performed to determine differences between noncannabis and cannabis inquiries and descriptive analyses were used to identify patterns within cannabis-specific inquiries. Results: Statistically significant differences between noncannabis and cannabis inquiries were observed. In addition, there were variations in MC and NMC inquiries. For example, 73% of MC inquiries originated from cancer survivors and caregivers, whereas almost half of NMC inquiries (48%) were from individuals identifying as tobacco users. MC and NMC inquiries also differed by CIS access channel (e.g., instant chat, telephone), language used (English vs. Spanish), discussions of cancer continuum phases and cancer sites, and referrals provided to individuals for additional information and resources. Conclusion: Cannabis-related information needs of the public-as documented by the CIS-varied by several factors. Health information sources such as the CIS can help address cannabis-related questions and concerns, while noting differences in who is inquiring, how, and why.

PMID:37856770 | DOI:10.1089/can.2023.0119

JCO Precis Oncol. 2023 Sep;7:e2300033. doi: 10.1200/PO.23.00033.

ABSTRACT

PURPOSE: To assess implementation of a next-generation sequencing (NGS) assay to detect microsatellite instability (MSI) as a screen for Lynch syndrome (LS) in endometrial cancer (EC), while determining and comparing characteristics of the four molecular subtypes.

METHODS: A retrospective review was performed of 408 total patients with newly diagnosed EC: 140 patients who underwent universal screening with NGS and 268 patients who underwent screening via mismatch repair immunohistochemistry (MMR IHC) as part of a historical screening paradigm. In the NGS cohort, incidental POLE and TP53 mutations along with MSI were identified and used to characterize EC into molecular subtypes: POLE-ultramutated, MSI high (MSI-H), TP53-mutated, and no specific molecular profile (NSMP). In historical cohorts, age- and/or family history-directed screening was performed with MMR IHC. Statistical analysis was performed using a t-test for continuous variables and chi-square or Fisher’s exact test for categorical variables.

RESULTS: In the NGS cohort, 38 subjects (27%) had MSI-H EC, 100 (71%) had microsatellite stable EC, and two (1%) had an indeterminate result. LS was diagnosed in two subjects (1%), and all but five patients completed genetic screening (96%). Molecular subtypes were ascertained: eight had POLE-ultramutated EC, 28 had TP53-mutated EC (20%), and 66 (47%) had NSMP. MSI-H and TP53-mutated EC had worse prognostic features compared with NSMP EC. Comparison with historical cohorts demonstrated a significant increase in follow-up testing after an initial positive genetic screen in the MSI NGS cohort (56% v 89%; P = .001).

CONCLUSION: MSI by NGS allowed for simultaneous screening for LS and categorization of EC into molecular subtypes with prognostic and therapeutic implications.

PMID:37856764 | DOI:10.1200/PO.23.00033

J Med Internet Res. 2023 Oct 18. doi: 10.2196/44795. Online ahead of print.

ABSTRACT

Lockdowns and border closures due to Coronavirus Disease 2019 (COVID-19) imposed mental, social, and financial hardships in many societies. Living with the virus and resuming normal life are increasingly being advocated with decreasing virus severity and widespread vaccine coverage. However, current trends indicate a continued absence of effective contingency plans to stop the next more virulent variant of the pandemic. The COVID-19-related mask waste crisis has also caused serious environmental problems and virus spreads. It is timely and important to consider how to precisely implement surveillance for dynamic clearance and how to efficiently manage discarded masks to minimize disease transmission and environmental hazards. In this viewpoint paper, we sought to address this issue by proposing an appropriate strategy for intelligent surveillance of infected cases and centralized management of mask waste. Such an intelligent strategy consisting of masklect and voiceprint against COVID-19 based on the STRONG strategy, could enable the resumption of social activities and economic recovery and ensure a safe public health environment sustainably.

PMID:37856760 | DOI:10.2196/44795

Am J Dermatopathol. 2023 Nov 1;45(11):748-752. doi: 10.1097/DAD.0000000000002555.

ABSTRACT

Acral lentiginous melanoma (ALM) is a relatively rare clinicopathologic subtype of cutaneous malignant melanoma, but it is the most common type of melanoma among Asians. Although the research to identify immunohistochemical (IHC) markers to differentiate nevi from melanoma is being conducted, specific markers for ALM are not well-known. Therefore, we aimed to analyze and compare the differences in the expression of melanocyte-associated IHC markers between ALM and acral benign nevi (ABN). Two independent groups of 53 and 19 paraffin-embedded specimens (from patients with pathologically confirmed ALM and ABN, respectively) were subjected to IHC staining for MART-1, preferentially expressed antigen in melanoma (PRAME), SOX10, HMB-45, Ki-67, and p16. We performed a quantitative analysis of PRAME, SOX10, KI-67, and p16 expression and gradient pattern analysis of HMB-45 expression for each specimen. The PRAME (60.1% and 28.5%, P < 0.05) and Ki-67 (7.8% and 3.5%, P < 0.05) expression levels were significantly higher in the ALM group than in the ABN group. The p16 expression was significantly lower (14.2% and 19.4%, P < 0.05), and the absence of HMB-45 gradient was more frequent in the ALM group than in the ABN group. However, no statistical significance was noted in SOX10 (54.8% and 44.7%). Receiver operating characteristic curves showed that PRAME had the highest area under the curve value. In summary, among various IHC markers, PRAME was the most valuable marker for the diagnosis of ALM; however, further large-scale studies are needed to validate these findings.

PMID:37856738 | DOI:10.1097/DAD.0000000000002555

J Glob Health. 2023 Oct 20;13:04127. doi: 10.7189/jogh.13.04127.

ABSTRACT

BACKGROUND: Given the increased risk of malnutrition in children with cleft lip and/or palate (CLP), determining their nutritional status is critical for preventing adverse surgical risks. However, no such disaggregated, national-level data are available in Indonesia. We aimed to determine the nutritional status of patients with clefts in Indonesia and to identify problems and solutions for malnutrition cases within the population.

METHODS: In this cross-sectional study, we considered records of individuals who underwent primary surgery for CLP in Smile Train-sponsored facilities in Indonesia between 1 January 2016 and 31 December 2021 (n = 18 480). We only included children under the age of five with an evaluation date prior to admission date and excluded subjects with invalid data values. We classified their nutritional status by z-scores according to the World Health Organization Child Growth Standard (2006). Malnutrition cases cover four indicators – stunting, wasting, underweight, and overweight. We compared the prevalence for malnutrition cases in children under the age of five using national health survey data.

RESULTS: We included 1899 records following data validation. The national prevalence of stunting (24.4%), wasting (12.5%), and overweight cases (12.9%) was high, while underweight cases (6.8%) were comparatively low. Statistical analyses showed significant differences in nutritional status based on length/height-for-age between girls and boys aged 0-5 months (P = 0.008) and 48-60 months (P = 0.001), and based on body mass index-for-age (P = 0.000) between girls and boys aged 0-5 months. Girls in different age groups exhibited a statistically significant difference in nutritional status based on length/height-for-age (P = 0.002) and weight-for-age (P = 0.017). Concurrent stunting and overweight were the most common forms of concurrent malnutrition (8.7%). We found a significant difference in the prevalence of underweight (P = 0.001) and overweight (P = 0.000) cases between children with CLP and those without CLP.

CONCLUSIONS: Our findings highlight the importance of nutritional interventions for children with orofacial clefts in Indonesia, and the importance of age and gender in their design and implementation. Further investigation is necessary to explore the risks of overweight and concurrent malnutrition among this population.

PMID:37856736 | DOI:10.7189/jogh.13.04127

Microsc Microanal. 2023 Oct 19:ozad116. doi: 10.1093/micmic/ozad116. Online ahead of print.

ABSTRACT

Collagen is the most abundant protein in mammals; it exhibits a hierarchical organization and provides structural support to a wide range of soft tissues, including blood vessels. The architecture of collagen fibrils dictates vascular stiffness and strength, and changes therein can contribute to disease progression. While transmission electron microscopy (TEM) is routinely used to examine collagen fibrils under normal and pathological conditions, computational tools that enable fast and minimally subjective quantitative assessment remain lacking. In the present study, we describe a novel semi-automated image processing and statistical modeling pipeline for segmenting individual collagen fibrils from TEM images and quantifying key metrics of interest, including fibril cross-sectional area and aspect ratio. For validation, we show first-of-their-kind illustrative results for adventitial collagen in the thoracic aorta from three different mouse models.

PMID:37856696 | DOI:10.1093/micmic/ozad116

Breastfeed Med. 2023 Oct;18(10):751-758. doi: 10.1089/bfm.2023.0115.

ABSTRACT

Objective: The aim of this study is to examine in-hospital exclusive breastfeeding (EBF) and its association with sociodemographic factors, medical factors, breastfeeding intentions, and health care system breastfeeding support. Materials and Methods: We conducted a retrospective cross-sectional study using medical records from 2015 to 2019 of healthy term infants without breastfeeding contraindications at a public teaching hospital serving a racially and ethnically diverse patient population. Using multivariable regression analysis, we examined the associations between in-hospital EBF and sociodemographic factors, medical factors, breastfeeding intentions, and health care system breastfeeding support (in-hospital breastfeeding education and lactation support). Results: The prevalence of in-hospital EBF was 29.0%. The statistically significant findings from our fully adjusted regression analysis include that there was a higher prevalence of in-hospital EBF among adult mothers (prevalence ratio [PR]: range 1.78-1.96), married mothers (PR: 1.35, 95% confidence interval [CI]: 1.23-1.44), and mothers who were White (PR: 1.41, 95% CI: 1.20-1.66, compared with Black). Factors associated with a lower prevalence of in-hospital EBF were maternal diabetes (PR: 0.82, 95% CI: 0.70-0.95), pre-eclampsia/eclampsia (PR: 0.82, 95% CI: 0.71-0.95), cesarean delivery (PR: 0.84, 95% CI: 0.77-0.92), neonatal hypoglycemia (PR: 0.46, 95% CI: 0.36-0.59), and intention in the prenatal period to formula feed only (PR: 0.15, 95% CI: 0.10-0.22). In-hospital lactation support was associated with higher prevalence of in-hospital EBF (PR: 1.24, 95% CI: 1.16-1.33). Conclusions: Prioritizing lactation support for Black mothers, adolescent mothers, those intending in the prenatal period to formula feed only, and mother-infant dyads with certain medical factors could improve in-hospital EBF.

PMID:37856663 | DOI:10.1089/bfm.2023.0115

Oral Dis. 2023 Oct 19. doi: 10.1111/odi.14779. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate whether genes in the Wnt pathway, which have been previously associated with both oral clefts and oral squamous cell carcinoma, are also associated with oral potentially malignant disorders (leukoplakia, erythroplakia and lichen planus).

MATERIALS AND METHODS: Case-control study: Dataset consisted of clinical information linked to DNA samples from affected subjects diagnosed with oral potential malignant disorders and oral cancer and their matched controls. Individual samples, clinical history, and potential risk factors were obtained through the Dental Registry and DNA Repository project of the School of Dental Medicine, University of Pittsburgh. The rs1533767 (WNT11), rs9879992 (GSK3B), and rs3923087 (AXIN2) were tested. After genomic DNA had been extracted, genotyping was performed blindly to clinical diagnosis status. Representation of genotypes and alleles in affected subjects in comparison to the unaffected individuals was determined using PLINK. Additional analysis was performed to investigate associations between environmental (socioeconomic/lifestyle) risk factors and the oral pathologies studied using STATA.

RESULTS: Two of the SNPs tested (rs9879992 in GSK3B and rs3923087 in AXIN2) were statistically, significantly associated with the pathologies studied (p = 0.039 and 0.038, respectively).

CONCLUSION: Single-nucleotide polymorphisms in genes in the Wnt pathway were associated with oral potentially malignant disorders.

PMID:37856649 | DOI:10.1111/odi.14779

Science. 2023 Oct 20;382(6668):270-272. doi: 10.1126/science.adi7521. Epub 2023 Oct 19.

ABSTRACT

New firm-level data can inform policy-making.

PMID:37856603 | DOI:10.1126/science.adi7521

Health Rep. 2023 Oct 18;34(10):13-23. doi: 10.25318/82-003-x202301000002-eng.

ABSTRACT

BACKGROUND: Canadian and international research has shown that the COVID-19 pandemic led to changes in health behaviours, including participation in physical activity and screen time.

METHODS: The Canadian Community Health Survey asks Canadian adults (aged 18 to 64 years) and older adults (aged 65 and older) to report the time they spend active by domain: recreation, transportation, and household and/or occupation. Survey respondents are also asked to report their screen time on days they worked and days they did not work. The present analysis compares the physical activity from four cross-sectional samples collected during 2018 (n=50,093), January to mid-March 2020 (n=13,933), September to December 2020 (n=25,661) and January 2021 to February 2022 (n=45,742). Screen time is compared between 2018 and 2021. Sub-annual analyses examine how physical activity and screen time varied within and between years.

RESULTS: The percentage of 18- to 64-year-old women meeting the physical activity recommendation did not change from 2018 (54.3%) to 2021 (55.1%), while a slight decrease was observed among men (63.0% in 2018 to 59.8% in 2021). The percentage of adults aged 65 years and older meeting the recommendation increased from 2018 to 2021 among both men (40.7% to 43.8%) and women (33.4% to 36.9%). Total physical activity decreased by 17.5 minutes per week among 18- to 64-year-old men and increased by 8.4 minutes per week among 18- to 64-year-old women. Men and women aged 65 and older increased their total physical activity by about 30 minutes per week from 2018 to 2021. The percentage of 18- to 64-year-old adults in the lowest screen time category decreased from 53.9% in 2018 to 45.0% in 2021 on work days and from 37.8% in 2018 to 28.0% in 2021 on non-work days. The percentage of adults aged 65 and older in the lowest screen time category decreased from 49.4% in 2018 to 37.8% in 2021 on work days and from 29.4% in 2018 to 21.5% in 2021 on non-work days.

INTERPRETATION: Physical activity among men aged 18 to 64 years decreased from 2018 to 2021, while women of this age group maintained their physical activity. Older adults increased their physical activity from 2018 to 2021. Many Canadian adults shifted from the lowest screen time category (two hours or less per day) to the highest screen time category (four hours or more per day) during the 2020 and 2021 pandemic years. It is unknown whether the short-term impact of the COVID-19 pandemic on physical activity and screen time will persist over time. Ongoing surveillance of the longer-term impacts of the pandemic on the health behaviours of Canadians is important.

PMID:37856572 | DOI:10.25318/82-003-x202301000002-eng