Nevin Manimala

Brachytherapy. 2022 Nov 8:S1538-4721(22)00321-X. doi: 10.1016/j.brachy.2022.09.160. Online ahead of print.

ABSTRACT

BACKGROUND: Locoregional failure is a unique and challenging problem in head and neck cancer with controversy surrounding the use of re-irradiation in the treatment. We aimed to evaluate the dosimetry and technical parameters in utilizing a collagen matrix with embedded Cesium-131 (Cs-131) radioactive isotope seeds as it relates to dose distribution and dose to carotid artery.

METHODS AND MATERIALS: Cadaveric feasibility study randomizing Cs-131 strands alone or Cs-131 with collagen matrix to be placed into neck dissection defects. For the dose computation, physicists employed the TG-43 dosimetry calculation algorithm with a point source assumption to compute the dose. Carotid arteries were contoured in MIM-Symphony software and the carotid artery maximum and mean doses were calculated in accordance with TG-43 specifications. Ease of use of collagen matrix tiles on a 7-point Likert scale and mean radiation dose to the carotid artery.

RESULTS: Ease of use score was higher in collagen matrix compared to stranded seeds with a mean score of 6.3 +/- 1.2 compared to 4.5 +/- 0.87. Time of implantation was statistically significantly, p = 0.031, lower in the collagen matrix group (M = 5.17 min, SD = 4.62) compared to stranded seeds (M = 15.83 min, SD = 3.24). Mean radiation dose to the carotid artery was 62.8 Gy +/- 9.46 in the collagen matrix group compared to 108.2 Gy +/- 55.6 in the traditional Cs-131 seeds group.

CONCLUSIONS: We present a feasibility and concept cadaveric study using a collagen matrix with Cesium-131 demonstrating preliminary evidence to support its ease of use, decreased time to implantation, and decreased dose delivered to the carotid artery.

PMID:36369194 | DOI:10.1016/j.brachy.2022.09.160

J Ethnobiol Ethnomed. 2022 Nov 11;18(1):66. doi: 10.1186/s13002-022-00563-3.

ABSTRACT

BACKGROUND: The apparency hypothesis in ethnobotany (common plants are used more than less frequent ones) has been studied mostly by comparing usefulness with woody plant density, or large plants (trees) with herbs, with uneven results. Here, we explore the hypothesis for wild-growing medicinal plants, separately for different life forms. Two methodological subjects relevant for testing the hypothesis are also treated: We compare various importance indicators, including recent use, and evaluate active healers’ knowledge of plant population size. The study area was the Tenancingo-Malinalco-Zumpahuacán Protected Natural Area in central Mexico in the upper part of the Balsas River Basin, a biogeographic region with a long tradition of using wild medicinal species.

METHODS: Previous work on the vegetation of the protected area contributed information from 100 survey plots and a species list, which included preliminary data on the medicinal plants. Then, in 2019-2020, we held in-depth and repeated interviews with 13 traditional healers in three rural communities. They were interviewed on uses and population size of a selection of 52 medicinal species of different life forms and abundance (number of individuals in survey plots). The data were analyzed with descriptive statistics, use values and linear regression models.

RESULTS: For all species, use value correlated significantly with abundance. When separated by life forms, only herbs and shrubs/lianas showed this association, though with statistical limitations. Trees did not, perhaps because some of the most useful trees have been overcollected. We found a good correlation of recent use with frequency of mention and most other importance indicators; the correlation was weakest for number of uses. Also, active healers had a good estimation of population of their collected species.

CONCLUSIONS: The apparency hypothesis should be studied separating life forms to reduce the influence of this variable. To measure importance for the study of this hypothesis, the data show that frequency of mention is a good indicator and correlated with actual use. Also, local plant users’ appreciations of population size are quite accurate in the aggregate and may be more efficient than costly vegetation surveys.

PMID:36369160 | DOI:10.1186/s13002-022-00563-3

Rev Colomb Psiquiatr (Engl Ed). 2022 Nov 8:S2530-3120(22)00061-3. doi: 10.1016/j.rcpeng.2020.12.002. Online ahead of print.

ABSTRACT

INTRODUCTION: Moritz et al.’s metacognitive training (MCT), a new development of cognitive therapy, is a manualised group training programme, designed to correct cognitive biases involved in the formation and maintenance of psychotic symptoms, especially delusions. We report on the efficacy of MCT in a Chilean sample of people with schizophrenia.

METHODS: 50 outpatients from the Hospital Del Salvador in Valparaíso, Chile, were randomly assigned to the intervention group that received MCT or the control group that only received treatment as usual (TAU). Subjects were assessed at the beginning and end of the study with the Positive and Negative Syndrome Scale (PANSS), Cognitive Biases Questionnaire for Psychosis (CBQ-P) and Beck Cognitive Insight Scale (BCIS).

RESULTS: Greater statistically significant improvements were recorded in the MCT group, both in symptoms and cognitive biases and in cognitive insight, than in the control group. When comparing both groups, significant results in favor of MCT were only observed in positive symptoms.

CONCLUSIONS: The results of this study suggest MCT is superior to TAU in treating positive symptoms. It was not possible to demonstrate its superiority in improving cognitive biases and cognitive insight.

PMID:36369153 | DOI:10.1016/j.rcpeng.2020.12.002

Nat Commun. 2022 Nov 11;13(1):6856. doi: 10.1038/s41467-022-34244-2.

ABSTRACT

Infection with SARS-CoV-2 virus is associated with a wide range of symptoms. The REal-time Assessment of Community Transmission -1 (REACT-1) study monitored the spread and clinical manifestation of SARS-CoV-2 among random samples of the population in England from 1 May 2020 to 31 March 2022. We show changing symptom profiles associated with the different variants over that period, with lower reporting of loss of sense of smell or taste for Omicron compared to previous variants, and higher reporting of cold-like and influenza-like symptoms, controlling for vaccination status. Contrary to the perception that recent variants have become successively milder, Omicron BA.2 was associated with reporting more symptoms, with greater disruption to daily activities, than BA.1. With restrictions lifted and routine testing limited in many countries, monitoring the changing symptom profiles associated with SARS-CoV-2 infection and effects on daily activities will become increasingly important.

PMID:36369151 | DOI:10.1038/s41467-022-34244-2

J Tissue Viability. 2022 Nov 7:S0965-206X(22)00116-4. doi: 10.1016/j.jtv.2022.11.001. Online ahead of print.

ABSTRACT

BACKGROUND: Subepidermal moisture (SEM) scanning is a novel technology that measures changes in localised oedema. Accumulation of subepidermal oedema is associated with early tissue damage that may lead to a pressure injury.

AIM: The primary study objective was to observe the variations in sacral subepidermal oedema levels over a continuous period of 60-degree head of bed elevation positioning.

METHODS: Healthy adult participants were recruited in this prospective observational study. Participants were positioned at 60-degree head of bed elevation for 120 min and sacral SEM measurements were collected at baseline and in 20 min increments.

RESULTS: A total of 20 participants with a mean age of 39.3 years (SD = 14.7) were recruited. The mean SEM delta value increased 6.3% from 0.46 SEM delta at baseline to 0.49 SEM delta after 120 min, however these differences are not statistically significant (p = .21). There were also no significant findings between SEM delta variations and demographic factors.

CONCLUSION: In a sample of healthy individuals, 120 min of continuous loading with a 60-degree head of bed elevation did not lead to a significant change in sacral subepidermal oedema levels. Further research on the response of healthy adult tissue under external forces associated with different angles of head of bed positioning may further contribute to our understanding pressure injury prevention.

PMID:36369143 | DOI:10.1016/j.jtv.2022.11.001

Transplant Proc. 2022 Nov 8:S0041-1345(22)00572-3. doi: 10.1016/j.transproceed.2022.08.030. Online ahead of print.

ABSTRACT

BACKGROUND: Graft-derived cell-free DNA (GcfDNA) is a promising biomarker for comprehensive monitoring of allograft injury because it overcomes the limitations of traditional approaches. The aim of this study is to investigate the association between the outliers of GcfDNA at initial time post transplantation and short-term renal graft function.

METHODS: A total of 230 recipients who underwent primary kidney transplantation were recruited in the study. For each recipient, 10 mL of peripheral blood were collected at day 1 post transplantation. Both of the GcfDNA fraction (%) and GcfDNA concentration (cp/mL) were determined using droplet digital PCR. The study was conducted in accordance with the 1964 Helsinki Declaration and its later amendments.

RESULTS: There were no values that fall outside of the lower extreme in both of the GcfDNA fraction and GcfDNA concentration, and the upper fence of GcfDNA fraction and GcfDNA concentration were 13.5% and 680 cp/mL, respectively. Recipients with GcfDNA concentration ≥680 cp/mL had a statistically significant higher serum creatinine at day 7 post-transplantation, when compared with the other group (P = .008). The receiver operating characteristic analysis obtained an area under the curve value of 0.869 when using GcfDNA concentration to predict the risk of serum creatinine ≥400 μmol/L, an optimal cut-off value was indicated at 975 cp/mL with high sensitivity (87.5%) and specificity (85%).

CONCLUSION: Our results suggest that the quantification of GcfDNA at initial time after transplantation might be used as a novel strategy for predicting short-term risk of impaired kidney allograft function or delayed graft function.

PMID:36369141 | DOI:10.1016/j.transproceed.2022.08.030

J Formos Med Assoc. 2022 Nov 8:S0929-6646(22)00391-6. doi: 10.1016/j.jfma.2022.10.007. Online ahead of print.

ABSTRACT

OBJECTIVES/BACKGROUND: Acute myeloid leukemia (AML) is the most common acute leukemia in adults, with high mortality. To date, there is no comprehensive population-based analysis of patients with AML in Asia, including Taiwan.

MATERIAL AND METHODS: This is a retrospective cohort study using three population-based databases, namely, the Taiwan Cancer Registry, Taiwanese National Health Insurance Research Database, and Taiwan Death Registry, between 2001 and 2015 to provide detailed information on patients with AML and relevant clinical variables, such as sex, age, year of diagnosis, socioeconomic status (SES) level, hospital level, treatment location, and Deyo-Charlson Comorbidity Index (Deyo-CCI) score.

RESULTS: Patients with newly diagnosed AML (n = 9949) were included in the study. The median age was 60 years, and the overall age-adjusted AML incidence over 15 years was 2.44 per 100,000 person-years. The median overall survival (OS) of patients younger than 65 years was 18 months, whereas the OS of patients older than age 65 was only 5 months. AML patients with a prior cancer history had the worst outcomes, and the acute promyelocytic leukemia subtype predicted better survival. Patients who were older, male and a higher Deyo-CCI score had a significantly higher risk of death. In contrast, patients with a higher SES level and receiving treatment in a medical center had a lower risk of mortality than their respective counterparts.

CONCLUSION: Our study results could enable clinicians to obtain a comprehensive picture of the epidemiology, survival outcomes and unmet medical needs of AML patients in Taiwan.

PMID:36369106 | DOI:10.1016/j.jfma.2022.10.007

Breast Cancer Res. 2022 Nov 11;24(1):77. doi: 10.1186/s13058-022-01578-0.

ABSTRACT

BACKGROUND: Associations of birthweight, childhood body size and pubertal timing with breast cancer risks by menopausal status and tumor receptor subtypes are inconclusive. Thus, we investigated these associations in a population-based cohort of Danish women.

METHODS: We studied 162,419 women born between 1930 and 1996 from the Copenhagen School Health Records Register. The register includes information on birthweight, measured childhood weights and heights at the age of 7-13 years, and computed ages at the onset of the growth spurt (OGS) and at peak height velocity (PHV). The Danish Breast Cancer Cooperative Group database provided information on breast cancer (n = 7510), including estrogen receptor (ER), human epidermal growth factor receptor 2 (HER2) and menopausal status. Hormone replacement therapy use came from the Danish National Prescription Registry. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated by Cox regression.

RESULTS: We found that birthweight was not associated with any breast cancer subtypes. While childhood BMI was not statistically significantly associated with ER+ tumors nor consistently with ER- tumors among pre-menopausal women, consistent inverse associations were found among postmenopausal women. At the age of 7 years, the HRs for postmenopausal ER+ and ER- tumors were 0.90 (95% CI 0.87-0.93) and 0.84 (95% CI 0.79-0.91) per BMI z-score, respectively. Similarly, childhood BMI was inversely associated with pre- and postmenopausal HER2- tumors, but not with HER2+ tumors. Childhood height was positively associated with both pre- and postmenopausal ER+ tumors, but not with ER- tumors. At the age of 7 years, the HRs for postmenopausal ER+ and ER- tumors were 1.09 (95% CI 1.06-1.12) and 1.02 (95% CI 0.96-1.09) per height z-score, respectively. In general, childhood height was positively associated with HER2+ and HER2- tumors among pre- and postmenopausal women. Ages at OGS and PHV were not associated with any breast cancer subtypes.

CONCLUSIONS: We showed that a high BMI and short stature in childhood are associated with reduced risks of certain breast cancer subtypes. Thus, childhood body composition may play a role in the development of breast cancer.

PMID:36369105 | DOI:10.1186/s13058-022-01578-0

Diabetol Metab Syndr. 2022 Nov 11;14(1):166. doi: 10.1186/s13098-022-00940-8.

ABSTRACT

BACKGROUND: Evidence showed possible benefits of a less gestational weight gain (GWG) than the US Institute of Medicine (IOM) recommendation in gestational diabetes mellitus (GDM) pregnancy. Here, we aimed to explore an appropriate GWG range in GDM women according to adverse pregnancy outcomes.

METHODS: We enrolled all the singleton GDM pregnant women (n = 14,213) from January 2015 to December 2018 in Xi’an, Northwest China. According to the pre-pregnancy body mass index (BMI), they were classified into the Underweight (< 18.5 kg/m²), Normal weight (18.5-24.9 kg/m²⁾, Overweight (25.0-29.9 kg/m²) and Obesity (≥ 30.0 kg/m²) group, respectively. Logistic regression analysis was used to calculate the odds ratio (OR) and 95% confidence intervals (95% CI). The appropriate ranges of GWG were determined based on a significant protective association (OR < 1).

RESULTS: Totally, 12,712 participants were finally recruited. There were 1180 (9.3%), 9134 (71.9%), 2097 (16.5%), and 301 (2.4%) patients in the Underweight, Normal weight, Overweight, and Obesity groups, respectively. Adverse outcomes increased with the elevation of pre-pregnancy BMI. Among them, the risk of cesarean section was the highest, followed by large for gestational age (LGA), small for gestational age (SGA), preeclampsia, and gestational hypertension. Through the analysis of the risk of adverse outcomes in continuous GWG categories in each group, an ideal GWG range obtained in this study was as follows: 10-15.9 kg, 8-11.9 kg, 6-7.9 kg, and -5-3.9 kg for the Underweight, Normal weight, Overweight and Obesity group, respectively. Furthermore, the ranges in this study were more protective for adverse outcomes than those from IOM.

CONCLUSIONS: Based on the adverse pregnancy outcomes of over 12 thousand participants, our findings showed a more stringent GWG range for GDM women than the IOM criteria recommendation.

PMID:36369083 | DOI:10.1186/s13098-022-00940-8

J Physiol Anthropol. 2022 Nov 11;41(1):39. doi: 10.1186/s40101-022-00314-z.

ABSTRACT

BACKGROUND: Spatial ability has been reported to indicate sex-based differences in humans, mainly assessed by Shepard and Metzler mental rotation task (SM-MRT). Most performances in earlier studies have been evaluated by the mean value of reaction time and/or accuracy. The performance indexes might not be sensitive measures of mental rotation. Sex-based differences in the performance might also be involved in the spatial experience of the subject at the time. This study observed variations in components of the SM-MRT over repetition.

METHODS: Male (n = 17) and female (n = 17) subjects completed 20 days of repeating the SM-MRT. The slope and intercept of the function performance (reaction time) to the angular disparity are calculated; the slope of this function indexes the mental rotation (main-process), and the intercept indexes the other sub-processes.

RESULTS: A significant main effect of sex was obtained on the slope. The intercept also showed a tendency toward statistical difference. The interactions between the sexes and the day were not significant for the indices. Statistical testing for coefficient of variations (CV) indicated no sex-based difference in the effect of the intercept throughout the experiment day. The CV of the slope, however, showed tendencies toward sex-based difference from days 7 to 12.

CONCLUSIONS: The difference between the sexes in performance on the slope was sustained throughout the experimental period. A few female subjects who demonstrated larger slope values than male subjects caused the sex difference. The learning rate of mental rotation may be an inherent spatial ability.

PMID:36369080 | DOI:10.1186/s40101-022-00314-z