Nevin Manimala

Front Public Health. 2023 Apr 28;11:1091709. doi: 10.3389/fpubh.2023.1091709. eCollection 2023.

ABSTRACT

Iran has invariably been under the growing public health threat of cutaneous leishmaniasis (CL), a significant barrier to local development that hinders the prevention and control efforts toward eliminating the disease. So far, no comprehensive and in-depth epidemiological analysis of the CL situation has been carried out nationwide. This study aimed to employ advanced statistical models to analyze the data collected through the Center for Diseases Control and Prevention of Communicable Diseases during 1989-2020. However, we emphasized the current trends, 2013-2020, to study temporal and spatial CL patterns. In the country, the epidemiology of CL is incredibly intricate due to various factors. This fact indicates that the basic infrastructure, the preceding supports, and the implementation plan related to preventive and therapeutic measures need crucial support. The leishmaniasis situation analysis is consistent with desperate requirements for efficient information on the control program in the area. This review provides evidence of temporally regressive and spatially expanding incidence of CL with characteristic geographical patterns and disease hotspots, signifying an urgent need for comprehensive control strategies. This information could be a suitable model and practical experience in the Eastern Mediterranean Region, where over 80% of CL is reported.

PMID:37188278 | PMC:PMC10176454 | DOI:10.3389/fpubh.2023.1091709

J Stroke Cerebrovasc Dis. 2023 May 13;32(8):107173. doi: 10.1016/j.jstrokecerebrovasdis.2023.107173. Online ahead of print.

ABSTRACT

BACKGROUND: To examine the reasonable duration of continuous electrocardiographic monitoring (CEM) to detect AF at acute ischemic stroke.

MATERIALS AND METHOD: 811 consecutive patients admitted to Tsuruga Municipal Hospital by acute ischemic stroke between April 2013 and December 2021 were enrolled in this study. Excluding 78 patients, 733 patients were analyzed by cluster analysis with SurvCART algorithm, followed by Kaplan-Meier analysis.

RESULTS: The analysis provided step graphs for 8 subgroups. The duration of CEM to achieve the sensitivity of 0.8, 0.9, and 0.95 in each could be calculated. The duration of CEM to achieve the sensitivity of 0.8 are 18 days in female patients with heart failure (HF) (subgroup 1), 24 days in male patients with HF (subgroup 2), 22 days in patients without HF with arterial occlusion and pulse rate (PR) more than 91 (subgroup 3), 24 days in patients without HF with occlusion with PR less than 91 (subgroup 4), 18 days in patients without HF without occlusion with lacuna (subgroup 5), 26 days in patients without HF, occlusion, and lacuna, with arterial stenosis (subgroup 6), 15 days in patients without HF, occlusion, lacuna, and stenosis with BMI more than 21%(subgroup 7), and 44 days in patients without HF, occlusion, lacuna, stenosis and with BMI less than 21% (subgroup 8).

CONCLUSIONS: Duration of CEM with the sensitivity of 0.8, 0.9, and 0.95 could be determined by presence of HF, female sex, arterial occlusion, PR more than 91/minute, presence of lacuna, presence of stenosis, and BMI more than 21%. (250).

PMID:37186969 | DOI:10.1016/j.jstrokecerebrovasdis.2023.107173

JCO Oncol Pract. 2023 May 15:OP2300043. doi: 10.1200/OP.23.00043. Online ahead of print.

ABSTRACT

PURPOSE: Multimodal care for cancer cachexia is needed. This study examined factors associated with practicing multimodal cachexia care among physicians and nurses engaging in cancer care.

METHODS: This was a preplanned secondary analysis of a survey investigating clinicians’ perspectives on cancer cachexia. Data of physicians and nurses were used. Data on knowledge, skills, and confidence in multimodal cachexia care were obtained. Nine items on practicing multimodal cachexia care were evaluated. Participants were divided into two groups as practicing multimodal cachexia care (above median value for the nine items) or not. Comparisons were made using the Mann-Whitney U test or chi-square test. Multiple regression analysis was performed to identify the factors of practicing the multimodal care.

RESULTS: Total of 233 physicians and 245 nurses were included. Significant differences were observed between the groups: female sex (P = .025), palliative care versus oncology specialization (P < .001), the number of clinical guidelines used (P < .001), the number of symptoms used (P = .005), training for cancer cachexia (P = .008), knowledge on cancer cachexia (P < .001), and confidence in cancer cachexia management (P < .001). Palliative care specialization (partial regression coefficient [B] = 0.85; P < .001), the number of clinical guidelines used (B = 0.44; P < .001), knowledge on cancer cachexia (B, 0.94; P < .001), and confidence in cancer cachexia management (B = 1.59; P < .001) were statistically significant in multiple regression analysis.

CONCLUSION: Specialization in palliative care, specific knowledge, and confidence were associated with the practice of multimodal care for cancer cachexia.

PMID:37186884 | DOI:10.1200/OP.23.00043

Proc Natl Acad Sci U S A. 2023 May 23;120(21):e2216765120. doi: 10.1073/pnas.2216765120. Epub 2023 May 15.

ABSTRACT

Urbanization extensively modifies surface roughness and properties, impacting regional climate and hydrological cycles. Urban effects on temperature and precipitation have drawn considerable attention. These associated physical processes are also closely linked to clouds’ formation and dynamics. Cloud is one of the critical components in regulating urban hydrometeorological cycles but remains less understood in urban-atmospheric systems. We analyzed satellite-derived cloud patterns spanning two decades over 447 US cities and quantified the urban-influenced cloud patterns diurnally and seasonally. The systematic assessment suggests that most cities experience enhanced daytime cloud cover in both summer and winter; nocturnal cloud enhancement prevails in summer by 5.8%, while there is modest cloud suppression in winter nights. Statistically linking the cloud patterns with city properties, geographic locations, and climate backgrounds, we found that larger city size and stronger surface heating are primarily responsible for summer local cloud enhancement diurnally. Moisture and energy background control the urban cloud cover anomalies seasonally. Under strong mesoscale circulations induced by terrains and land-water contrasts, urban clouds exhibit considerable nighttime enhancement during warm seasons, which is relevant to strong urban surface heating interacting with these circulations, but other local and climate impacts remain complicated and inconclusive. Our research unveils extensive urban influences on local cloud patterns, but the effects are diverse depending on time, location, and city properties. The comprehensive observational study on urban-cloud interactions calls for more in-depth research on urban cloud life cycles and their radiative and hydrologic implications under the urban warming context.

PMID:37186862 | DOI:10.1073/pnas.2216765120

Proc Natl Acad Sci U S A. 2023 May 23;120(21):e2213836120. doi: 10.1073/pnas.2213836120. Epub 2023 May 15.

ABSTRACT

In recent years, cellular biomechanical properties have been investigated as an alternative to morphological assessments for oocyte selection in reproductive science. Despite the high relevance of cell viscoelasticity characterization, the reconstruction of spatially distributed viscoelastic parameter images in such materials remains a major challenge. Here, a framework for mapping viscoelasticity at the subcellular scale is proposed and applied to live mouse oocytes. The strategy relies on the principles of optical microelastography for imaging in combination with the overlapping subzone nonlinear inversion technique for complex-valued shear modulus reconstruction. The three-dimensional nature of the viscoelasticity equations was accommodated by applying an oocyte geometry-based 3D mechanical motion model to the measured wave field. Five domains-nucleolus, nucleus, cytoplasm, perivitelline space, and zona pellucida-could be visually differentiated in both oocyte storage and loss modulus maps, and statistically significant differences were observed between most of these domains in either property reconstruction. The method proposed herein presents excellent potential for biomechanical-based monitoring of oocyte health and complex transformations across lifespan. It also shows appreciable latitude for generalization to cells of arbitrary shape using conventional microscopy equipment.

PMID:37186851 | DOI:10.1073/pnas.2213836120

Proc Natl Acad Sci U S A. 2023 May 23;120(21):e2301707120. doi: 10.1073/pnas.2301707120. Epub 2023 May 15.

ABSTRACT

[C. Koch, S. Ullman, Hum. Neurobiol.4, 219-227 (1985)] proposed a 2D topographical salience map that took feature-map outputs as its input and represented the importance “saliency” of the feature inputs at each location as a real number. The computation on the map, “winner-take-all,” was used to predict action priority. We propose that the same or a similar map is used to compute centroid judgments, the center of a cloud of diverse items. [P. Sun, V. Chu, G. Sperling, Atten. Percept. Psychophys.83, 934-955 (2021)] demonstrated that following a 250-msec exposure of a 24-dot array of 3 intermixed colors, subjects could accurately report the centroid of each dot color, thereby indicating that these subjects had at least three salience maps. Here, we use a postcue, partial-report paradigm to determine how many more salience maps subjects might have. In 11 experiments, subjects viewed 0.3-s flashes of 28 to 32 item arrays composed of M, M = 3,…,8, different features followed by a cue to mouse-click the centroid of items of just the post-cued feature. Ideal detector response analyses show that subjects utilized at least 12 to 17 stimulus items. By determining whether a subject’s performance in (M-1)-feature experiments could/could-not predict performance in M-feature experiments, we conclude that one subject has at least 7 and the other two have at least five salience maps. A computational model shows that the primary performance-limiting factors are channel capacity for representing so many concurrently presented groups of items and working-memory capacity for so many computed centroids.

PMID:37186842 | DOI:10.1073/pnas.2301707120

Proc Natl Acad Sci U S A. 2023 May 23;120(21):e2216234120. doi: 10.1073/pnas.2216234120. Epub 2023 May 15.

ABSTRACT

Neurodegenerative diseases, such as Alzheimer’s disease (AD), are associated with protein misfolding and aggregation into amyloid fibrils. Increasing evidence suggests that soluble, low-molecular-weight aggregates play a key role in disease-associated toxicity. Within this population of aggregates, closed-loop pore-like structures have been observed for a variety of amyloid systems, and their presence in brain tissues is associated with high levels of neuropathology. However, their mechanism of formation and relationship with mature fibrils have largely remained challenging to elucidate. Here, we use atomic force microscopy and statistical theory of biopolymers to characterize amyloid ring structures derived from the brains of AD patients. We analyze the bending fluctuations of protofibrils and show that the process of loop formation is governed by the mechanical properties of their chains. We conclude that ex vivo protofibril chains possess greater flexibility than that imparted by hydrogen-bonded networks characteristic of mature amyloid fibrils, such that they are able to form end-to-end connections. These results explain the diversity in the structures formed from protein aggregation and shed light on the links between early forms of flexible ring-forming aggregates and their role in disease.

PMID:37186840 | DOI:10.1073/pnas.2216234120

Technol Cancer Res Treat. 2023 Jan-Dec;22:15330338231170495. doi: 10.1177/15330338231170495.

ABSTRACT

BACKGROUND: The incorporation of noncoplanar beam arrangements has been proposed in liver radiotherapy modalities, which can reduce the dose in normal tissues compared to coplanar techniques. Noncoplanar radiotherapy techniques for hepatocellular carcinoma treatment based on the Linac design have a limited effective arc angle to avoid collisions.

PURPOSE: To propose a novel noncoplanar volumetric modulated arc therapy technique based on a cage-like radiotherapy system and investigate its performance in hepatocellular carcinoma patients.

METHODS: The computed tomography was deflected 90° to meet the structure of a cage-like radiotherapy system and design the noncoplanar volumetric modulated arc therapy technique based on a cage-like radiotherapy system plan in the Pinnacle3 planning system. An noncoplanar volumetric modulated arc therapy technique based on a cage-like radiotherapy system plan was customized for each of 10 included hepatocellular carcinoma patients, with 6 dual arcs ranging from -30° to 30°. Six couch angles were set with an interval of 36° and distributed along with the longest diameter of planning target volume. The dosimetric parameters of noncoplanar volumetric modulated arc therapy technique based on a cage-like radiotherapy system plan were compared with the noncoplanar volumetric modulated arc therapy and volumetric modulated arc therapy plan.

RESULTS: The 3 radiotherapy techniques regarding planning target volume were statistically different for D98%, D2%, conformity index, and homogeneity index with χ² = 9.692, 14.600, 8.600, and 12.600, and P = .008, .001, .014, and .002, respectively. Further multiple comparisons revealed that noncoplanar volumetric modulated arc therapy technique based on a cage-like radiotherapy system significantly reduced the mean dose (P = .005) and V5 (P = .005) of the normal liver, the mean dose (P = .005) of the stomach, and V30 (P = .028) of the lung compared to noncoplanar volumetric modulated arc therapy. Noncoplanar volumetric modulated arc therapy technique based on a cage-like radiotherapy system significantly reduced the mean dose (P = .005) and V5 (P = .005) of the normal liver, the mean dose (P = .017) of the spinal cord, V50 (P = .043) of the duodenum, the maximum dose (P = .007) of the esophagus, and V30 (P = .047) of the whole lung compared to volumetric modulated arc therapy. The results indicate that noncoplanar volumetric modulated arc therapy technique based on a cage-like radiotherapy system protects the normal liver, stomach, and lung better than noncoplanar volumetric modulated arc therapy and protects the normal liver, spinal cord, duodenum, esophagus, and lung better than volumetric modulated arc therapy.

CONCLUSIONS: The noncoplanar volumetric modulated arc therapy technique based on a cage-like radiotherapy system technique with the arrangement of noncoplanar arcs provided optimal dosimetric gains compared with noncoplanar volumetric modulated arc therapy and volumetric modulated arc therapy, except for the heart. Noncoplanar volumetric modulated arc therapy technique based on a cage-like radiotherapy system should be considered in more clinically challenging cases.

PMID:37186800 | DOI:10.1177/15330338231170495

Can J Occup Ther. 2023 Jun;90(2):161-172. doi: 10.1177/00084174231160954.

ABSTRACT

Background. Physical activity (PA) is essential for maintaining well-being in adults with disabilities. This population experienced reduced PA during the COVID-19 pandemic; yet, the impact on quality of PA participation remains unclear. Purpose. This secondary analysis explored how pandemic restrictions impacted six experiential dimensions of quality of PA participation among adults with disabilities. Methods. An exploratory sequential mixed-methods design, including semi-structured interviews (n = 10) and self-reported surveys (n = 61), was conducted in May-2020 and February-2021. Quality of PA participation was measured using the Measure of Experiential Aspects of Participation (MeEAP). Participants included community-dwelling adults over 19 years of age (mean 59.2 ± 14.0 years) living with stroke, spinal cord injury, or other physical disabilities. Findings. Directed content analysis identified three themes related to adjusting PA participation for restrictions, motivation barriers, and valuing social support. These themes highlighted five factors, such as resilience, as potential quantitative predictors of quality of PA participation. While paired correlations with MeEAP scores were observed, these factors were not statistically predictive in multiple regression analysis (adjusted R² = -0.14, F(10,50) = 0.92, p = .53). Implications. The interplay between Meaning, Autonomy, Engagement, and Belongingness dimensions of quality of PA participation was complex, with an emphasized role for mental health, in adults with disabilities.

PMID:37186790 | DOI:10.1177/00084174231160954

Clin Rehabil. 2023 May 15:2692155231172009. doi: 10.1177/02692155231172009. Online ahead of print.

ABSTRACT

OBJECTIVE: To examine the proportion of people with aphasia (PwA) included and retained in randomised controlled trials (RCTs) of stroke interventions published in the previous 6 years, as well as aphasia-relevant eligibility criteria and inclusion/retention strategies.

DATA SOURCES: Comprehensive searching of Embase, PubMed and Medline (Ovid) for the period January 2016 – November 2022.

REVIEW METHODS: RCTs examining stroke interventions targeting cognition, psychological wellbeing/health-related quality of life (HRQL), multidisciplinary rehabilitation, and self-management were included. Methodological quality was assessed using the Critical Appraisal Skills Programme (CASP) Randomised Controlled Trial checklist. Descriptive statistics were applied to extracted data, and results were reported narratively.

RESULTS: Fifty-seven RCTs were included. These examined self-management (32%), physical (26%) psychological wellbeing/HRQL (18%), cognitive (14%), and multidisciplinary (11%) interventions. Of 7313 participants, 107 (1.5%) had aphasia and were included in three trials. About one-third did not report on aphasia (32%); over one quarter required functional communication (28%); one quarter excluded all aphasia (25%); and 14% excluded severe aphasia. No aphasia-specific inclusion/retention strategies were available.

CONCLUSION: The findings highlight ongoing under-representation. However, due to shortcomings in aphasia reporting, the findings may underestimate actual inclusion rate. Excluding PwA has implications for the external validity, effectiveness, and implementation of stroke research findings. Triallists may require support in aphasia research strategies and methodological reporting.

PMID:37186769 | DOI:10.1177/02692155231172009