Nevin Manimala

Clin Colorectal Cancer. 2023 Mar 4:S1533-0028(23)00024-5. doi: 10.1016/j.clcc.2023.02.007. Online ahead of print.

ABSTRACT

INTRODUCTION/BACKGROUND: Adjuvant capecitabine monotherapy is an option for colon and upper rectum adenocarcinoma patients, providing they have stage II disease with an intermediate risk of recurrence, or stage III but they are above 70’s or they have comorbidities. We wanted to examine whether the number of chemotherapy cycles and the relative dose intensity (RDI) of capecitabine monotherapy in the adjuvant setting are affecting disease recurrence.

PATIENTS AND METHODS: We included patients with completely resected stage II and III colon and upper rectum cancer who received adjuvant capecitabine monotherapy, from 2003 until May 2020. Patients with early relapse, i.e. during chemotherapy or within 6 months after the completion of adjuvant chemotherapy, and those with rectal cancer who received radiotherapy were excluded. Patients were divided into 3 groups based on the number of chemotherapy cycles received and the RDI. Group A included patients with ≤4 cycles of chemotherapy, group B patients with >4 cycles of chemotherapy and RDI ≤80%, and group C patients with >4 cycles of chemotherapy and RDI >80%. Study’s endpoint, was recurrence free survival (RFS).

RESULTS: Two hundred twenty six patients with stage II and III disease (164 and 62 respectively) were included. Sixteen, 166 and 44 were included in groups A, B and C respectively. After a median follow-up of 41 months, 21 patients (9,3%) had relapsed. Patients belonging to group C were found to have a trend for lower relapse rate compared to patients belonging to group A or group B.

CONCLUSION: Number of adjuvant capecitabine cycles and RDI might play a role in RFS in patients with stage II and III colon and upper rectum adenocarcinoma.

PMID:36967268 | DOI:10.1016/j.clcc.2023.02.007

Med Educ Online. 2023 Dec;28(1):2189558. doi: 10.1080/10872981.2023.2189558.

ABSTRACT

Evidence-informed data may help students matching into competitive residency programs guide curricular activities, extracurricular activities, and residency career choices. We aimed to examine the characteristics of students applying to competitive surgical residencies and identify predictors of matching success. We identified the five lowest match rates for the surgical subspecialities listed in the 2020 National Resident Matching Program report to define a surgical residency as competitive. We analyzed a database from 115 United States medical schools regarding application data from 2017 to 2020. Multilevel logistic regression was used to determine predictors of matching. Statistical significance was set at p < 0.05.A total of 1,448 medical students submitted 25,549 applications. The five most competitive specialties included were plastic surgery (N = 172), otolaryngology (N = 342), neurological surgery (N = 163), vascular surgery (N = 52), orthopedic surgery (N = 679), and thoracic surgery (N = 40). We found that medical students with a geographical connection (adjusted OR, 1.65 [95% CI, 1.41 to 1.93]), and students who did an away rotation at the applied program (adjusted OR, 3.22 [95% CI, 2.75 to 3.78]) had statistically significantly increased odds of matching into a competitive surgical specialty. Furthermore, we found that students with a United States Medical Licensing Examination (USMLE) Step 1 score below 230 and Step 2 Clinical Knowledge (CK) score below 240 had increased odds of matching if they completed an away rotation at the applied program. Completing an away rotation and geographical connection to the institution may contribute more than academic criteria for selection into a competitive surgical residency after an interview. This finding may be due to less variation in academic criteria among this pool of high-performing medical students. Students with limited resources who apply to a competitive surgical specialty may be at a disadvantage given the financial burden of an away rotation.

PMID:36966504 | DOI:10.1080/10872981.2023.2189558

Ann Nucl Med. 2023 Mar 26. doi: 10.1007/s12149-023-01831-2. Online ahead of print.

NO ABSTRACT

PMID:36966481 | DOI:10.1007/s12149-023-01831-2

Pest Manag Sci. 2023 Mar 26. doi: 10.1002/ps.7480. Online ahead of print.

ABSTRACT

BACKGROUND: Stable flies (Stomoxys calcitrans (L.)) are economically important pests of cattle and other livestock. As an alternative to conventional insecticides, we tested a push-pull management strategy using a coconut oil fatty acid repellent formulation and an attractant-added stable fly trap.

RESULTS: In our field trials we found that weekly applications of a push-pull strategy can reduce stable fly populations on cattle as well as a standard insecticide (permethrin). We also found that the efficacy period of the push-pull and permethrin treatments following on-animal application were equivalent. Traps with an attractant lure used as the pull component of the push-pull strategy captured sufficient numbers of stable flies to reduce on-animal numbers by an estimated 17 to 21 percent.

CONCLUSIONS: This is the first proof of concept field trial demonstrating the effectiveness of a push-pull strategy using a coconut oil fatty acid-based repellent formulation and traps with an attractant lure to manage stable flies on pasture cattle. Also notable is that the push-pull strategy had an efficacy period equivalent to that of a standard, conventional insecticide under field conditions. This article is protected by copyright. All rights reserved.

PMID:36966475 | DOI:10.1002/ps.7480

Biochem Genet. 2023 Mar 26. doi: 10.1007/s10528-023-10364-2. Online ahead of print.

ABSTRACT

Hypertension (HTN) is a global health challenge and increase the risk of cardiovascular disease. Hypertension has a multifactorial course of evolution, with both genetic and environmental factors playing an important role. To date, a number of genes and pathways have been proposed to be associated with HTN, among which is Nitric Oxide pathway. NO levels can be regulated by reactive oxygen species (ROS), superoxide and post-transcriptional mechanisms, including sense-anti sense interactions. NOS3AS gene encodes an antisense RNA (sONE) which is complementary to NOS3 transcript in 662 nucleotides and may regulate NOS3 in a post-transcriptional manner. In this study, we sought to define the role of NOS3AS in the pathophysiology of essential HTN. A total of 131 cases with hypertension and 115 controls were enrolled in the study. Peripheral blood was drawn from all study participants after signing the informed consent form. Three variants (rs71539868, rs12666075 and rs7830) were investigated by Tetra-ARMS PCR method. The results were then statistically analyzed. We found statistically significant association between rs7830 TT genotype, rs12666075 GT and TT genotypes with susceptibility to HTN. We failed to observe association between rs71539868 and susceptibility to HTN. The present study showed a strong association between NOS3AS variants and susceptibility to hypertension in the population of Kermanshah province. Our results may shed more light on the mechanisms of disease development and may also help to better identify genetic predispositions and individuals at risk.

PMID:36966459 | DOI:10.1007/s10528-023-10364-2

Ann Neurol. 2023 Mar 26. doi: 10.1002/ana.26647. Online ahead of print.

ABSTRACT

INTRODUCTION: Lower education is associated with higher burden of vascular risk factors in mid-life and higher risk of dementia in late life. We aim to understand the causal mechanism through which vascular risk factors potentially mediate the relationship between education and dementia.

METHODS: In a cohort of 13,368 Black and White older adults in the Atherosclerosis Risk in Communities Study, we assessed the relationship between education (grade school, high school without graduation, high school graduate or equivalent, college, graduate/professional school) and dementia among all participants and among those with incident stroke. Cox models were adjusted for age, race-center (a variable stratified by race and field center), sex, APOE ε4 genotype, and family history of cardiovascular disease. Causal mediation models assessed mediation by mid-life systolic blood pressure, fasting blood glucose, body mass index and smoking.

RESULTS: More education was associated with 8-44% lower risk of dementia compared to grade school-level education in a dose-response pattern, while the relationship between education and post-stroke dementia was not statistically significant. Up to 25% of the association between education and dementia was mediated through mid-life vascular risk factors, with a smaller percentage mediated for lower levels of education.

INTERPRETATION: A substantial proportion of the relationship between education and dementia was mediated through mid-life vascular risk factors. However, risk factor modification is unlikely to fully address the large educational disparities in dementia risk. Prevention efforts must also address disparities in socioeconomic resources leading to divergent early-life education and other structural determinants of mid-life vascular risk factors. This article is protected by copyright. All rights reserved.

PMID:36966451 | DOI:10.1002/ana.26647

J Immigr Minor Health. 2023 Mar 26. doi: 10.1007/s10903-023-01469-2. Online ahead of print.

ABSTRACT

Incorporating cultural sensitivity into healthcare settings is important to deliver high-quality and equitable care, particularly for marginalized communities who are non-White, non-English speaking, or immigrants. The Clinicians’ Cultural Sensitivity Survey (CCSS) was developed as a patient-reported survey assessing clinicians’ recognition of cultural factors affecting care quality for older Latino patients; however, this instrument has not been adapted for use in pediatric primary care. Our objective was to examine the validity and reliability of a modified CCSS that was adapted for use with parents of pediatric patients. A convenience sampling approach was used to identify eligible parents during well-child visits at an urban pediatric primary care clinic. Parents were administered the CCSS via electronic tablet in a private location. We first conducted exploratory factor analyses (EFAs) to explore the dimensionality of survey responses in the adapted CCSS, and then conducted a series of confirmatory factor analyses (CFAs) using maximum likelihood estimation based on the results of the EFAs. Exploratory and confirmatory factor analyses (N = 212 parent surveys) supported a three-factor structure assessing racial discrimination ([Formula: see text]=0.96), culturally-affirming practices ([Formula: see text]=0.86), and causal attribution of health problems ([Formula: see text]=0.85). In CFAs, the three-factor model also outperformed other potential factor structures in terms of fit statistics including scaled root mean square error approximation (0.098), Tucker-Lewis Index (0.936), Comparative Fit Index (0.950), and demonstrated adequate fit according to the standardized root mean square residual (0.061). Our findings support the internal consistency, reliability, and construct validity of the adapted CCSS for use in a pediatric population.

PMID:36966449 | DOI:10.1007/s10903-023-01469-2

Isotopes Environ Health Stud. 2023 Mar 26:1-10. doi: 10.1080/10256016.2023.2189249. Online ahead of print.

ABSTRACT

For the first time, a map of the ²²²Rn gas has been produced in the Campania region, the southern part of Italy, based on the activity concentration measured in indoor environments. This work is part of the radon mitigation policy and complies with the recent Italian Legislative Decree 101/2020, which implements the European Basic Safety Standards, Euratom Directive 59/2013, where Member States must declare areas with elevated levels of indoor radon concentration. The obtained map, divided by Campania municipalities, identifies priority areas with activity concentration values exceeding the reference level of 300 Bq m^-3. In addition, an effective statistical analysis of the dataset has been carried out.

PMID:36966417 | DOI:10.1080/10256016.2023.2189249

Biotechnol Genet Eng Rev. 2023 Mar 26:1-12. doi: 10.1080/02648725.2023.2193059. Online ahead of print.

ABSTRACT

To investigate the effects of combining a “six heart” nursing model intervention with comfortable nursing in patients suffering from primary liver cancer receiving radiotherapy. Between March 2017 to March 2022, 70 patients having liver cancer who received radiotherapy at our hospital were chosen and separated into observation and control groups employing the random number table technique, and each group consisted of 35 cases. Patients of the observation group received “six heart” nursing model intervention in addition to comfort nursing based on conventional intervention, while the control group’s patients received standard nursing intervention during radiotherapy. After the intervention, the observation groups’ scores and total scores of physical and emotional burden and the scores of escaping and yielding were significantly lower than those of the control group, with statistically significant differences (P<0.05). Following the intervention, each dimension’s scores, total score and of the resilience scale and the scores of general well-being and quality of life of the observation group were significantly greater in comparison to the control group, with statistically significant differences (P<0.05). The observation group’s overall nursing satisfaction rate was 100.00%, which showed a statistically significant difference from the control group’s 85.71 (P<0.05). “Six heart” nursing model intervention combined with comfortable nursing can help reduce patients’ self-perceived burden, improve psychological resilience, improve patients’ general well-being and quality of life.

PMID:36966377 | DOI:10.1080/02648725.2023.2193059

Endocr Regul. 2023 Mar 26;57(1):53-60. doi: 10.2478/enr-2023-0007. Print 2023 Jan 1.

ABSTRACT

Objective. Nowadays, type 2 diabetes mellitus (T2D) is the most common chronic endocrine disorder affecting an estimated 5-10% of adults worldwide, and this disease also rapidly increased among the population in the Kurdistan region. This research aims to identify DNA methylation change in the TCF7L2 gene as a possible predictive T2D biomarker. Methods. One hundred and thirteen participants were divided into three groups: diabetic (47), prediabetic (36), and control (30). The study was carried out in patients who visited the private clinical sector between August and December 2021 in Koya city (Iraq Kurdistan region) to determine DNA methylation status using a methylation-specific PCR (MSP) with paired primers for each methylated and non-methylated region. In addition, the X2 Kruskal-Wallis statistical and Wilcoxon signed-rank tests were used, p<0.05 was considered significant. Results. The results showed hypermethylation of DNA in the promoter region in diabetic and prediabetic groups compared to the healthy controls. Different factors affected the DNA methylation level, including body max index, alcohol consumption, family history, and physical activity with the positive Coronavirus. Conclusion. The results obtained indicate that DNA methylation changes in the TCF7L2 promoter region may be used as a potential predictive biomarker of the T2D diagnosis. However, the findings obtained in this study should be supported by additional data.

PMID:36966366 | DOI:10.2478/enr-2023-0007