Nevin Manimala

Ann Nucl Med. 2023 Oct 5. doi: 10.1007/s12149-023-01870-9. Online ahead of print.

ABSTRACT

OBJECTIVES: MotionFree® (AMF) is a data-driven respiratory gating (DDG) algorithm for image processing that has recently been introduced into clinical practice. The present study aimed to verify the accuracy of respiratory waveform and the effects of normal and irregular respiratory motions using AMF with the DDG algorithm.

METHODS: We used a NEMA IEC body phantom comprising six spheres (37-, 28-, 22-, 17-, 13-, and 10 mm diameter) containing ¹⁸F. The sphere-to-background ratio was 4:1 (21.2 and 5.3 kBq/mL). We acquired PET/CT images from a stationary or moving phantom placed on a custom-designed motion platform. Respiratory motions were reproduced based on normal (sinusoidal or expiratory-paused waveforms) and irregular (changed amplitude or shifted baseline waveforms) movements. The “width” parameters in AMF were set at 10-60% and extracted data during the expiratory phases of each waveform. We verified the accuracy of the derived waveforms by comparing those input from the motion platform and output determined using AMF. Quantitative accuracy was evaluated as recovery coefficients (RCs), improvement rate, and %change that were calculated based on sphere diameter or width. We evaluated statistical differences in activity concentrations of each sphere between normal and irregular waveforms.

RESULTS: Respiratory waveforms derived from AMF were almost identical to the input waveforms on the motion platform. Although the RCs in each sphere for expiratory-paused and ideal stationary waveforms were almost identical, RCs except the expiratory-paused waveform were lower than those for the stationary waveform. The improvement rate decreased more for the irregular, than the normal waveforms with AMF in smaller spheres. The %change was improved by decreasing the width of waveforms with a shifted baseline. Activity concentrations significantly differed between normal waveforms and those with a shifted baseline in spheres < 28 mm.

CONCLUSIONS: The PET images using AMF with the DDG algorithm provided the precise waveform of respiratory motions and the improvement of quantitative accuracy in the four types of respiratory waveforms. The improvement rate was the most obvious in expiratory-paused waveforms, and the most subtle in those with a shifted baseline. Optimizing the width parameter in irregular waveform will benefit patients who breathe like the waveform with the shifted baseline.

PMID:37796394 | DOI:10.1007/s12149-023-01870-9

Curr Atheroscler Rep. 2023 Oct 5. doi: 10.1007/s11883-023-01151-w. Online ahead of print.

ABSTRACT

PURPOSE OF REVIEW: This review aimed to determine the association between statin use and coronary artery calcification (CAC), as detected by computed tomography in the general population, in previously published observational studies (OSs) and randomized controlled trials (RCTs).

RECENT FINDINGS: A systematic search until February 2022 identified 41 relevant studies, comprising 29 OSs and 12 RCTs. We employed six meta-analysis models, stratifying studies based on design and effect metrics. For cohort studies, the pooled β of the association with CAC quantified by the Agatston score was 0.11 (95% CI = 0.05; 0.16), with an average follow-up time per person (AFTP) of 3.68 years. Cross-sectional studies indicated a pooled odds ratio of 2.11 (95% CI = 1.61; 2.78) for the presence of CAC. In RCTs, the pooled standardized mean differences (SMDs) for CAC, quantified by Agatston score or volume, over and AFTP of 1.25 years were not statistically significant (SMD = – 0.06, 95% CI = – 0.19; 0.06 and SMD = 0.26, 95% CI = – 0.66; 1.19), but significantly different (p-value = 0.04). Meta-regression and subgroup analyses did not show any significant differences in pooled estimates across covariates. The effect of statins on CAC differs across study designs. OSs demonstrate associations between statin use and higher CAC scores and presence while being prone to confounding by indication. Effects from RCTs do not reach statistical significance and vary depending on the quantification method, hampering drawing conclusions. Further investigations are required to address the limitations inherent in each approach.

PMID:37796384 | DOI:10.1007/s11883-023-01151-w

Can J Public Health. 2023 Oct 5. doi: 10.17269/s41997-023-00817-x. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine factors associated with COVID-19 vaccination (time to vaccination and vaccination status) among healthy young children participating in primary healthcare.

METHODS: A cohort study was conducted between November 2021 and September 2022 through the TARGet Kids! primary care research network in Toronto, Canada. Sociodemographic information, child and parent health characteristics, parental vaccine beliefs and child COVID-19 vaccine uptake were collected through parent-reported questionnaires. The primary outcome was time to child COVID-19 vaccination, measured as the time between vaccine availability date and parent-reported child COVID-19 vaccination date. Interval-censored proportional hazard models were used.

RESULTS: A total of 267 children age 0 to 13 years were included. The mean child age was 7.6 years, 52.8% (n = 141) were male, 66.5% (n = 141) had mothers of European ethnicity (with missingness), and 68.2% (n = 182) of the children were vaccinated. All parents of vaccinated children had received the COVID-19 vaccination themselves. The rate of vaccination for children was 2% higher with each one-month increase in child age (adjusted HR = 1.02, 95%CI = 1.01-1.03, p < 0.001). Compared to children whose parents had uncertain beliefs, those whose parents had positive beliefs about the importance and safety of COVID-19 vaccination for their children had higher rates of vaccination (adjusted HR = 8.29, 95%CI = 4.25-16.17, p < 0.001; adjusted HR = 5.09, 95%CI = 3.17-8.17, p < 0.001).

CONCLUSION: Older child age, parental COVID-19 vaccination, and positive parental beliefs about COVID-19 vaccination were statistically significantly associated with COVID-19 vaccination among healthy young children. Our findings may help to inform policies, practices, and research which aim to strengthen parental vaccine confidence and promote child COVID-19 vaccination.

PMID:37796366 | DOI:10.17269/s41997-023-00817-x

Breast Cancer Res Treat. 2023 Oct 5. doi: 10.1007/s10549-023-07104-w. Online ahead of print.

ABSTRACT

PURPOSE: Sentinel lymph node biopsy (SLNB) has yet to be accepted as the standard staging procedure in node positive (cN1) breast cancer patients who had clinical complete response in the axilla (cN0) following neoadjuvant chemotherapy (NAC), due to the presumed high false negative rate associated with SLNB in such scenario. This study aimed to determine whether there is a significant difference in the axillary recurrence rate (ARR) and long-term survival in this group of patients, receiving SLNB alone versus axillary lymph node dissection (ALND).

METHODS: A retrospective cohort of cN1 patients who were rendered cN0 by NAC from January 2014 to December 2018 were identified from the Asan Medical Center database. Patients’ characteristics and outcomes were collected and analyzed.

RESULTS: 902 cN1 patients treated with NAC and turned cN0 were identified. 477 (52.9%) patients achieved complete pathological response in the axilla (ypN0). At a median follow up of 65 months, ARR was 3.2% in the SLNB only group and 1.8% in the ALND group (p = 0.398). DFS and OS were significantly worse in patients with ALND as compared to patients with SLNB only (p = 0.011 and 0.047, respectively). We noted more patients in the ALND group had T3-4 tumor. In the subgroup analysis, we showed that in the T1-2 subgroup (n = 377), there was no statistically significant difference in DFS and OS (p = 0.242 and 0.671, respectively) between SLNB only and ALND group.

CONCLUSION: Our findings suggest that cN1 patients who were converted to ypN0 following NAC may be safely treated with SLNB only.

PMID:37796365 | DOI:10.1007/s10549-023-07104-w

Environ Sci Pollut Res Int. 2023 Oct 5. doi: 10.1007/s11356-023-30091-w. Online ahead of print.

ABSTRACT

Brevibacillus laterosporus ZR-11, a bio-control strain, was innovatively inoculated at maturity stage of composting to clarify its effect on physicochemical parameters and indigenous bacterial community structure in compost pile. Results revealed that ZR-11 inoculum rapidly increased pile temperature to 52 ºC and raised germination index (GI) value to beyond 85% on day 3, thereby achieving higher pile temperature and GI in the inoculated group than the non-inoculated group almost along maturity stage, and also decreased C/N ratio of the inoculated group to below 20 by composting end (day 8). Also, ZR-11 succeeded in colonizing compost pile along maturity stage. These suggested that ZR-11 as inoculum at maturity stage could accelerate compost maturation and have a potential to participate in bio-fertilizer production. High-throughput sequencing indicated that bacterial community structure experienced substantial succession in the inoculated and non-inoculated groups, and Firmicutes, Proteobacteria, and Actinobacteria were the dominant phyla in the two groups during maturity stage, with their abundances higher in the inoculated group. Saccharomonospora and Ammoniibacillus abundance increased on day 3 while Actinomadura abundance increased on day 6 in the inoculated group. As verified statistically, pile temperature and pH were key factors closely linked to dominant genera abundance, where Saccharomonospora and Ammoniibacillus abundance were positively correlated to pile temperature, while Actinomadura abundance was positively correlated to pile pH. Thus, it was inferred that ZR-11 inoculum could improve parameters such as temperature and pH to modify dominant genera abundance, thus regulating indigenous bacterial community succession, which might in turn promote compost maturation.

PMID:37796351 | DOI:10.1007/s11356-023-30091-w

Plant Cell. 2023 Oct 5:koad247. doi: 10.1093/plcell/koad247. Online ahead of print.

ABSTRACT

NAKED ENDOSPERM1 (NKD1), NKD2 and OPAQUE2 are transcription factors important for cell patterning and nutrient storage in maize (Zea mays) endosperm. To study the complex regulatory interrelationships among these three factors in co-regulating gene networks, we developed a set of nkd1, nkd2 and o2 homozygous lines, including all combinations of mutant and wild-type genes. Among the eight genotypes tested, we observed diverse phenotypes and gene interactions affecting cell patterning, starch content, and storage proteins. From ∼8 to ∼16 days after pollination, maize endosperm undergoes a transition from cellular development to nutrient accumulation for grain filling. Gene network analysis showed that NKD1, NKD2 and O2 dynamically regulate a hierarchical gene network during this period, directing cellular development early, then transitioning to constrain cellular development while promoting the biosynthesis and storage of starch, proteins and lipids. Genetic interactions regulating this network are also dynamic. The assay for transposase-accessible chromatin using sequencing (ATAC-seq) showed that O2 influences the global regulatory landscape, decreasing NKD1 and NKD2 target site accessibility, while NKD1 and NKD2 increase O2 target site accessibility. In summary, interactions of NKD1, NKD2 and O2 dynamically affect the hierarchical gene network and regulatory landscape during the transition from cellular development to grain filling in maize endosperm.

PMID:37795691 | DOI:10.1093/plcell/koad247

Psychol Med. 2023 Sep;53(12):5405-5414. doi: 10.1017/S003329172200246X. Epub 2022 Aug 24.

ABSTRACT

BACKGROUND: Preschool psychiatric symptoms significantly increase the risk for long-term negative outcomes. Transdiagnostic hierarchical approaches that capture general (‘p’) and specific psychopathology dimensions are promising for understanding risk and predicting outcomes, but their predictive utility in young children is not well established. We delineated a hierarchical structure of preschool psychopathology dimensions and tested their ability to predict psychiatric disorders and functional impairment in preadolescence.

METHODS: Data for 1253 preschool children (mean age = 4.17, s.d. = 0.81) were drawn from three longitudinal studies using a similar methodology (one community sample, two psychopathology-enriched samples) and followed up into preadolescence, yielding a large and diverse sample. Exploratory factor models derived a hierarchical structure of general and specific factors using symptoms from the Preschool Age Psychiatric Assessment interview. Longitudinal analyses examined the prospective associations of preschool p and specific factors with preadolescent psychiatric disorders and functional impairment.

RESULTS: A hierarchical dimensional structure with a p factor at the top and up to six specific factors (distress, fear, separation anxiety, social anxiety, inattention-hyperactivity, oppositionality) emerged at preschool age. The p factor predicted all preadolescent disorders (ΔR² = 0.04-0.15) and functional impairment (ΔR² = 0.01-0.07) to a significantly greater extent than preschool psychiatric diagnoses and functioning. Specific dimensions provided additional predictive power for the majority of preadolescent outcomes (disorders: ΔR² = 0.06-0.15; functional impairment: ΔR² = 0.05-0.12).

CONCLUSIONS: Both general and specific dimensions of preschool psychopathology are useful for predicting clinical and functional outcomes almost a decade later. These findings highlight the value of transdiagnostic dimensions for predicting prognosis and as potential targets for early intervention and prevention.

PMID:37795688 | DOI:10.1017/S003329172200246X

J Infect Dis. 2023 Oct 5:jiad420. doi: 10.1093/infdis/jiad420. Online ahead of print.

ABSTRACT

BACKGROUND: Varicella is a highly infectious disease, particularly affecting children, that can lead to complications requiring antibiotics or hospitalization. Antibiotic use for varicella management is poorly documented. This study assessed antibiotic use for varicella and its complications in a pediatric population in England.

METHODS: Data were drawn from medical records in the Clinical Practice Research Datalink and Hospital Episode Statistics datasets. Patients <18 years old diagnosed with varicella during 2014-2018 with 3-month follow-up available were included. We described varicella-related complications, medication use, healthcare resource utilization, and costs from diagnosis until 3-month post-diagnosis.

RESULTS: We identified 114,578 children with a primary varicella diagnosis. 7.7% (n = 8,814) had a varicella-related complication, the most common being ear, nose, and throat related (37.1%, n = 3,271). In all, 25.9% (n = 29,706/114,578) were prescribed antibiotics. A higher proportion of patients with complications than those without complications were prescribed antibiotics (64.3%, n = 5,668/8,814 vs. 22.7%, n = 24,038/105,764). Mean annualized varicella-related costs were £2,231,481 for the study cohort. Overall, antibiotic prescriptions cost ∼£262,007.

CONCLUSIONS: This study highlights high antibiotic use and healthcare resource utilization associated with varicella management, particularly in patients with complications. A national varicella vaccination program in England may reduce varicella burden and related complications, medication use, and costs.

PMID:37795662 | DOI:10.1093/infdis/jiad420

Pediatr Obes. 2023 Oct 5:e13079. doi: 10.1111/ijpo.13079. Online ahead of print.

ABSTRACT

BACKGROUND: Energy balance-related behaviours (EBRBs), that is, dietary intake, screen, outdoor play and sleep, tend to combine into ‘lifestyle patterns’, with potential synergistic influences on health. To date, studies addressing this theme mainly focused on school children and rarely accounted for sleep, with a cross-country perspective.

OBJECTIVES: We aimed at comparing lifestyle patterns among preschool-aged children across Europe, their associations with socio-demographic factors and their links with body mass index (BMI).

METHODS: Harmonized data on 2-5-year-olds participating in nine European birth cohorts from the EU Child Cohort Network were used (EBRBs, socio-demographics and anthropometrics). Principal component analysis and multivariable linear and logistic regressions were performed.

RESULTS: The most consistent pattern identified across cohorts was defined by at least three of the following EBRBs: discretionary consumption, high screen time, low outdoor play time and low sleep duration. Consistently, children from low-income households and born to mothers with low education level had higher scores on this pattern compared to their socioeconomically advantaged counterparts. Furthermore, it was associated with higher BMI z-scores in the Spanish and Italian cohorts (β = 0.06, 95% CI = [0.02; 0.10], both studies).

CONCLUSION: These findings may be valuable in informing early multi-behavioural interventions aimed at reducing social inequalities in health at a European scale.

PMID:37795656 | DOI:10.1111/ijpo.13079

Clin Physiol Funct Imaging. 2023 Oct 5. doi: 10.1111/cpf.12857. Online ahead of print.

ABSTRACT

BACKGROUND: SGLT2 inhibitors have been shown to reduce hospitalization in patients with chronic heart failure (CHF). The cardioprotective mechanisms of gliflozins however have not been fully elucidated. Aim of this study was therefore to evaluate the effect of SGLT2 inhibitors on right and left ventricular function in patients with diabetes and HF.

METHODS: Seventy-eight patients with diabetes and CHF were enrolled in the study and followed up; 38 started treatment with SGLT2i, while the remaining 40 continued their previous antidiabetic therapy. All patients underwent conventional, TDI and strain echocardiography in an ambulatory setting, at the beginning and after 3 months of therapy with SGLT2i.

RESULTS: After 3 months of therapy with SGLT2i, echocardiographic parameters assessing both left and right ventricular dimensions and function were found as significantly improved in patients switching to SGLT2i than control group: LVEF (45±9% vs 40±8%, p<0.001), LVEDD (54±6.5 vs 56±6.5 mm, p<0.01), GLS (-13±4% vs -10±3%, p<0.001), TAPSE (21±3 vs 19±3 mm, p<0.001), RV S’ (13±2.5 vs 11±2, p<0.001), and PAsP (24±8 vs 31±9 mmHg, p<0.001). Also mitral (1.0±0.5 vs 1.3±0.5, p<0.01) and tricuspid regurgitation (1.0±0.5 vs 1.3±0.5, p<0.01) improved after SGLT2i therapy. Changes were not statistically significant in patients not treated with SGLT2i (p n.s. in all cases).

CONCLUSIONS: In a real-world scenario, treatment with SGLT2i in patients with CHF and diabetes is associated with an improvement in both left and right ventricular function assessed at echocardiography. These data may explain potential anti-remodelling effects of gliflozins. This article is protected by copyright. All rights reserved.

PMID:37795627 | DOI:10.1111/cpf.12857