Nevin Manimala

BMC Genomics. 2023 Apr 10;24(1):192. doi: 10.1186/s12864-023-09295-4.

ABSTRACT

BACKGROUND: Genetic correlations between complex traits suggest that pleiotropic variants contribute to trait variation. Genome-wide association studies (GWAS) aim to uncover the genetic underpinnings of traits. Multivariate association testing and the meta-analysis of summary statistics from single-trait GWAS enable detecting variants associated with multiple phenotypes. In this study, we used array-derived genotypes and phenotypes for 24 reproduction, production, and conformation traits to explore differences between the two methods and used imputed sequence variant genotypes to fine-map six quantitative trait loci (QTL).

RESULTS: We considered genotypes at 44,733 SNPs for 5,753 pigs from the Swiss Large White breed that had deregressed breeding values for 24 traits. Single-trait association analyses revealed eleven QTL that affected 15 traits. Multi-trait association testing and the meta-analysis of the single-trait GWAS revealed between 3 and 6 QTL, respectively, in three groups of traits. The multi-trait methods revealed three loci that were not detected in the single-trait GWAS. Four QTL that were identified in the single-trait GWAS, remained undetected in the multi-trait analyses. To pinpoint candidate causal variants for the QTL, we imputed the array-derived genotypes to the sequence level using a sequenced reference panel consisting of 421 pigs. This approach provided genotypes at 16 million imputed sequence variants with a mean accuracy of imputation of 0.94. The fine-mapping of six QTL with imputed sequence variant genotypes revealed four previously proposed causal mutations among the top variants.

CONCLUSIONS: Our findings in a medium-size cohort of pigs suggest that multivariate association testing and the meta-analysis of summary statistics from single-trait GWAS provide very similar results. Although multi-trait association methods provide a useful overview of pleiotropic loci segregating in mapping populations, the investigation of single-trait association studies is still advised, as multi-trait methods may miss QTL that are uncovered in single-trait GWAS.

PMID:37038103 | DOI:10.1186/s12864-023-09295-4

Ann Palliat Med. 2023 Apr 10:apm-22-1296. doi: 10.21037/apm-22-1296. Online ahead of print.

ABSTRACT

Opioids are the backbone of cancer pain management. Minimal evidence exists examining the relationship between cancer type and opioid dose. Similarly, the use of adjuvant analgesics and its impact within an inpatient cancer setting is understudied. This study examined the influence of cancer type upon opioid dose, measured by oral morphine equivalent daily dose (oMEDD). The effect of adjuvant analgesics on patient oMEDD was also examined. This retrospective cross-sectional study examined records of 520 patients admitted to Royal Melbourne Hospital or Peter MacCallum Cancer Centre between 2016 and 2018 with advanced cancer. Number and dose of both opioid and adjuvant analgesics were collected along with demographic and cancer data. Comparisons of median oMEDD by cancer type [analysis of variance (ANOVA), non-parametric t-tests] and adjuvant analgesics (Kruskal-Wallis test) were performed. There were no statistically significant differences in oMEDD between the 12 cancer types (P=0.83; n=215). Patients co-prescribed pregabalin (n=102) and paracetamol (n=73) as adjuvant analgesics were on significantly higher daily oMEDD [60 mg (P=0.015), 90 mg (P<0.001), respectively]. Opioid dose did not differ significantly between cancer types. The observed use of adjuvant analgesics coincided with significantly higher oMEDD prescription which may relate to complex pain seen in this cohort of inpatients in a quarternary cancer centre. Future research should focus on pain type and aetiology, and pain scores in different cancer pain syndromes to determine the net effect of opioids and adjuvants in cancer pain prescribing.

PMID:37038083 | DOI:10.21037/apm-22-1296

Ann Palliat Med. 2023 Mar 16:apm-22-811. doi: 10.21037/apm-22-811. Online ahead of print.

ABSTRACT

BACKGROUND: Preoperative anxiety is a common problem in pregnant women undergoing elective cesarean section. We aimed to determine the anxiolytic effects of chewing gum in pregnant women undergoing elective cesarean section under regional anesthesia.

METHODS: This was a single-center, prospective, randomized controlled trial. Sixty-six women were randomly assigned to either the control group (n=33) or gum group (n=33) in a 1:1 ratio. In the gum group, the participants chewed xylitol gum for at least 10 min/h, regardless of fasting. Gum chewing was started at 5 pm a day before surgery and continued till the participant entered the operation room. In the control group, participants were requested to follow fasting guidelines without further instruction. The primary outcome was preoperative anxiety measured using the Amsterdam Preoperative Anxiety and Information Scale (APAIS) immediately before surgery.

RESULTS: The APAIS score immediately before surgery showed no significant difference between the control and the gum group (19.2±5.8 vs. 19.1±4.1, P>0.99). There were no statistically significant differences in the eight items related to anxiety: unfitness, concentration difficulty, hunger, thirst, dry mouth, fatigue, headache, and nausea. However, the pain score during the procedure of combined spinal epidural anesthesia was significantly lower in the chewing gum group [4 (IQR, 3-5.5)] than in the control group [5 (IQR, 3-7), P=0.045].

CONCLUSIONS: Preoperative gum chewing did not reduce anxiety levels measured immediately before entering the operating room in the participants undergoing elective cesarean section.

TRIAL REGISTRATION: Clinical Trial Registry of Korea; https://cris.nih.go.kr/cris/index.jsp and identifier: KCT0006602; date of registration: September 27, 2021; principal investigator’s name: RyungA Kang).

PMID:37038062 | DOI:10.21037/apm-22-811

Ann Palliat Med. 2023 Mar 9:apm-22-994. doi: 10.21037/apm-22-994. Online ahead of print.

ABSTRACT

BACKGROUND: Palliative care interventions improve quality-of-life for advanced cancer patients and their caregivers. The frequency and quality of service provision could be improved by a clinical tool that helps oncology professionals to assess unmet needs for palliative care interventions and to structure the interventions delivered. This paper aims to answer the following research question: what do oncology professionals and cancer patients view as important elements in a clinical tool for assessing unmet palliative care needs? Based on the feedback from professionals and patients, we developed and refined an intervention-focused clinical tool for use in cancer care.

METHODS: This study used a prospective convergent mixed methods design and was carried out at a single tertiary hospital in Switzerland. Healthcare professionals participated in focus groups (n=29) and a Delphi survey (n=73). Patients receiving palliative care were interviewed (n=17). Purposive sampling was used to achieve maximal variation in participant response. Inductive content analysis and descriptive statistics were used to analyze focus group discussions, open-ended survey questions and interview data. Descriptive statistics were used for analyzing quantitative survey items and interviewee characteristics.

RESULTS: Focus groups and Delphi surveys showed that seven key palliative care interventions were important to oncology professionals. They also valued a tool that could be used by doctors, nurses, or other professionals. Participants did not agree about the best timepoint for assessment. Two versions of a pilot clinical tool were tested in patient interviews. Interviews highlighted the divergent patient needs that must be accommodated in clinical practice. Patients provided confirmation that a clinical tool would be helpful to them.

CONCLUSIONS: This paper reports on research carried out to understand what elements are most important in a tool that helps oncology professionals to identify patients’ unmet needs and provide tailored palliative care interventions. This study demonstrated that professionals and patients alike are interested in a clinical tool. Responses from oncology healthcare professionals helped to identify relevant palliative care interventions, and patients provided constructive input used in designing a tool for use in clinical interactions.

PMID:37038058 | DOI:10.21037/apm-22-994

Acad Psychiatry. 2023 Apr 10. doi: 10.1007/s40596-023-01773-x. Online ahead of print.

ABSTRACT

OBJECTIVE: Over the last decade, there has been an increased focus on firearm use in violent acts and suicides. There is no known published firearm safety curriculum specific to psychiatric training and limited guidance on curriculum development from national organizations. The authors’ goals were to develop a firearm lecture series that would encompass essential knowledge related to firearm safety and risk assessments and assess its effect on psychiatric residents’ interest and confidence in firearm safety guidance.

METHODS: The authors developed a six-lecture series on firearm safety that was conducted over all post-graduate year (PGY) training levels and a grand rounds on basic firearm safety. All levels of psychiatry residents at one urban academic center participated in a pre- and post-lecture series questionnaire designed to evaluate attitudes related to firearm safety guidance. They developed and administered the questionnaire through New Innovations collecting qualitative and quantitative data for analysis. The quantitative analysis was completed using paired t-test.

RESULTS: Forty-seven residents participated. Twenty-seven respondents met inclusion criteria: attended at least one lecture or the grand rounds, completed pre- and post-lecture surveys, and submitted their pre-lecture survey before their first lecture. After the educational intervention, there was a statistically significant increase (p<0.05) in interest in firearm safety, and confidence in all areas surveyed-risk assessment, safety guidance, and pertinent legislation.

CONCLUSIONS: The curriculum increased residents’ interest and confidence in providing firearm safety guidance. Areas of development include assessing the curriculum’s impact on clinical practice.

PMID:37038043 | DOI:10.1007/s40596-023-01773-x

J Oral Pathol Med. 2023 Apr 10. doi: 10.1111/jop.13432. Online ahead of print.

ABSTRACT

BACKGROUND: The ABO and Rh systems are the most commonly used blood-group systems used to classify blood group globally. A number of studies have shown that ABO blood groups may be associated with an increased serum cholesterol levels which in turn may be related to the presence of oral Fordyce spots or granules. Oral Fordyce’s granules are ectopic sebaceous glands within the oral cavity and are visible through epithelium. The aim of this study was to assess the relationship between ABO and Rhesus blood groups and the presence of oral Fordyce’s granules and serum cholesterols level by gender.

METHODS: Following ethical approval and informed consent, 124 subjects were recruited into this cross-sectional study. Clinical oral examination assessed the number of Fordyce’s granules and blood samples were collected to determine the serum cholesterol and ABO/Rh blood-group systems of individual subjects.

RESULTS: Blood group AB⁺ showed the highest mean of oral Fordyce’s granules number and serum cholesterol level but this was not statistically significant compared to other blood groups. Female subjects in this study who were AB⁺ were had significantly higher serum cholesterol levels than males.

CONCLUSION: This study indicates an association between ABO blood group, serum cholesterol level and mean number of oral Fordyce’s granules. A larger sample size in a future study is required to ascertain whether number of Fordyce’s granules is an important measure of serum cholesterol, but the study does show that for AB⁺ individuals, females may have higher serum cholesterol than males.

PMID:37038041 | DOI:10.1111/jop.13432

Psychon Bull Rev. 2023 Apr 10. doi: 10.3758/s13423-023-02254-w. Online ahead of print.

ABSTRACT

In 2007, Cheng and colleagues published their influential review wherein they analyzed the literature on spatial cue interaction during navigation through a Bayesian lens, and concluded that models of optimal cue integration often applied in psychophysical studies could explain cue interaction during navigation. Since then, numerous empirical investigations have been conducted to assess the degree to which human navigators are optimal when integrating multiple spatial cues during a variety of navigation-related tasks. In the current review, we discuss the literature on human cue integration during navigation that has been published since Cheng et al.’s original review. Evidence from most studies demonstrate optimal navigation behavior when humans are presented with multiple spatial cues. However, applications of optimal cue integration models vary in their underlying assumptions (e.g., uninformative priors and decision rules). Furthermore, cue integration behavior depends in part on the nature of the cues being integrated and the navigational task (e.g., homing versus non-home goal localization). We discuss the implications of these models and suggest directions for future research.

PMID:37038031 | DOI:10.3758/s13423-023-02254-w

Surg Endosc. 2023 Apr 10. doi: 10.1007/s00464-023-10047-4. Online ahead of print.

ABSTRACT

BACKGROUND: Metabolic syndrome is a known risk factor for postoperative complications after general surgical procedures. Literature analyzing perioperative outcomes of patients with metabolic syndrome undergoing a minimally invasive hepatectomy is limited. We sought to investigate if metabolic syndrome significantly impacts the perioperative course and outcomes of patients undergoing robotic hepatectomy.

METHODS: With IRB, we prospectively followed patients who underwent robotic hepatectomy from 2016 through 2020. A 1:1 propensity score-matched (PSM) analysis was applied to patients with and without metabolic syndrome. Demographic and clinical data were analyzed for those cohorts before and after PSM. Metabolic syndrome was defined as BMI ≥ 28.8 kg/m², diabetes, and hypertension.

RESULTS: A total of 272 patients underwent robotic hepatectomy, 39 (14%) of whom had metabolic syndrome. After performing PSM, we ended up with 74 patients, 37 in each cohort, 28% of them had liver cirrhosis. Patients with metabolic syndrome had higher BMI (34 ± 5.6 vs. 28 ± 5.9 kg/m², p < 0.001) and MELD scores (10 ± 4.5 vs. 8 ± 3.2, p < 0.001) compared to patients without metabolic syndrome. Additionally, patients with metabolic syndrome had an increased incidence of liver cirrhosis (33% vs. 9%, p = 0.0002). Following PSM, BMI (34 ± 5.7 vs. 26 ± 4.4 kg/m², p < 0.001) was the only preoperative variables associated with metabolic syndrome. There were no statistical differences before and after PSM between patients with and without metabolic syndrome in terms of intraoperative metrics including operative time, blood loss, conversion to ‘open,’ and intraoperative complications. All postoperative outcomes metrics before and after PSM did not correlate with the presence or absence of metabolic syndrome.

CONCLUSIONS: Metabolic syndrome had no impact on intra- or postoperative metrics, complications, or outcomes after robotic hepatectomy. We believe that the robotic approach may mitigate the adverse effects of metabolic syndrome for patients undergoing robotic hepatectomy.

PMID:37038021 | DOI:10.1007/s00464-023-10047-4

Poult Sci. 2023 Mar 17;102(6):102661. doi: 10.1016/j.psj.2023.102661. Online ahead of print.

ABSTRACT

Avian infectious bronchitis (IB) is a highly contagious disease caused by infectious bronchitis virus (IBV). Vaccination is an effective approach for controlling IBV. Therefore, reliable immune monitoring for IB is critical for poultry. In this study, a novel peptide derived from S2 protein was used to develop an enzyme-linked immunosorbent assay (ELISA) for the detection of broadly cross-reactive antibodies against IBV. The peptide-based ELISA (pELISA) showed good specificity and sensitivity in detecting IBV antibodies against different serotypes. A semilogarithmic regression method for determining IBV antibody titers was also established. Antibody titers detected by pELISA and calculated with this equation were statistically similar to those evaluated by indirect fluorescence assay (IFA). Moreover, the comparison analysis showed a 96.07% compatibility between the pELISA and IDEXX ELISA. All these data demonstrate that the pELISA generated here can be as a rapid and reliable serological surveillance tool for monitoring IBV infection or vaccination.

PMID:37037098 | DOI:10.1016/j.psj.2023.102661

Gynecol Oncol. 2023 Apr 8;173:15-21. doi: 10.1016/j.ygyno.2023.03.023. Online ahead of print.

ABSTRACT

OBJECTIVES: To describe stage, treatment patterns, and survival for glassy cell carcinoma of the cervix (GCCC), a poorly understood rare tumor.

METHODS: Clinical data and survival were compared between GCCC and more common histologic types using the National Cancer Database (NCDB) from 2004 to 2017. A retrospective review of GCCC cases at our institution from 2012 to 2020 was simultaneously performed with staging updated according to 2018 FIGO staging. Descriptive statistics and survival analyses were performed, and outcomes compared to historical references.

RESULTS: 143/89,001 (0.16%) NCDB cervical cancer cases were GCCC. Compared to other histologies, GCCC cases were younger, with 74.8% diagnosed before age 50. Stage distribution was similar. Stage I cases were less commonly treated with surgery alone (19/69, 27%). 79.4% of locally advanced (stage II-IVA) cases were treated with definitive chemoradiation. GCCC demonstrated worse OS for early-stage and locally-advanced disease. No survival differences were observed for patients with stage IVB disease. Our institutional review identified 14 GCCC cases. Median age at diagnosis was 34 years. All nine early-stage cases underwent radical hysterectomy. Adjuvant radiation was given for cases meeting Sedlis criteria (4/9, 44%). All five advanced stage cases were stage IIIC and received definitive chemoradiation. Recurrence rate was 0% (0/9) for early-stage and 60% (3/5) for advanced-stage cases. 3-year PFS was 100% for early-stage and 40% for advanced-stage. 3-year OS was 100% for early-stage and 60% for advanced-stage GCCC.

CONCLUSIONS: GCCC presents at earlier ages than other cervical cancer histologic types. Although NCDB showed worse OS, our more contemporary institutional review, which incorporates updated staging and newer treatment modalities found outcomes more similar to historical references of more common histologic subtypes.

PMID:37037083 | DOI:10.1016/j.ygyno.2023.03.023