Nevin Manimala

Front Pediatr. 2022 Mar 3;10:795019. doi: 10.3389/fped.2022.795019. eCollection 2022.

ABSTRACT

BACKGROUND: The efficacy and safety of impregnated central venous catheters (CVCs) in pediatrics remain controversial. The purpose of this study was to evaluate the efficacy of impregnations for the prevention of catheter-related bloodstream infection (CRBSI).

METHODS: We searched the following five electronic databases: Medline, PubMed, Cochrane, Embase, and the Web of Science for randomized controlled trials (RCTs) up to March 2021. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using a fixed-effects model. Assessment of publication biases was evaluated by Egger’s test. Heterogeneity between studies was assessed based on the chi-square test and I ² statistics, and sensitivity analysis and subgroup analysis were also performed.

RESULTS: A total of six RCTs with 3,091 patients were included. Impregnated CVCs provided significant benefits in reducing the risk of CRBSI (RR = 0.41, 95% CI: 0.26-0.66) in pediatric patients, especially in the pediatric group. No publication bias was observed in the Egger test for the risk of CRBSI. Drug type is a source of heterogeneity.

CONCLUSION: Antimicrobial-impregnated CVCs are beneficial to prevent CVC-related complications in pediatrics.

PMID:35311042 | PMC:PMC8927082 | DOI:10.3389/fped.2022.795019

Int J Endocrinol. 2022 Mar 10;2022:7847011. doi: 10.1155/2022/7847011. eCollection 2022.

ABSTRACT

Chronic skin wound caused by diabetic disease is very common worldwide. Moreover, there is a shortage of effective curing technology in clinic. In this work, we developed a novel technology using thermosensitive hydrogel on wound top combined with insulin injection. The efficiency and mechanism of this technology were investigated in a diabetic mouse model. Dorsal-paired 8-10 mm diameter wounds were created in 12 mice. The wound healing rate was determined over a 28-day interval in healthy control (Control), control with diabetes (DControl), poloxamer treatment (Pox), and poloxamer plus insulin injection (Poxin) mice. Histological specimens were observed in all samples. Real-time quantitative polymerase chain reaction (qRT-PCR) was performed to measure the relative expression of α-smooth muscle actin (α-SMA) and transforming growth factor beta 1 (TGF-β1) in wound tissues at 7, 14, and 28 days. Compared with DControl animals, those treated with Poxin showed accelerated wound closure and healing rate (p < 0.05); expression of both α-SMA and TGF-β1 was significantly higher than that of the DControl and Pox animals during the first 7 days postoperation, but a significant decrease at day 14. Therefore, we concluded that hydrogel combined with insulin accelerated wound healing. Controlling the glucose level via insulin injection is more beneficial than hydrogel alone for healing chronic wounds, potentially through the increase of α-SMA and TGF-β1 expression in early phase.

PMID:35311032 | PMC:PMC8930262 | DOI:10.1155/2022/7847011

Int J Endocrinol. 2022 Mar 10;2022:3830380. doi: 10.1155/2022/3830380. eCollection 2022.

ABSTRACT

INTRODUCTION: The interactions of central obesity and body composition with thyroid hormones and the hypothalamus-pituitary-adrenal (HPA) axis are unclear; both central obesity and body composition have an impact on energy homeostasis. Our study aimed to investigate the association between body composition and pituitary hormones, including the HPA axis and pituitary-thyroid axis, in a Chinese population of euthyroid overweight and obese individuals.

METHODS: This was a cross-sectional study. Overweight and obese patients who regularly visited the multidisciplinary team (MDT) for obesity at Peking University First Hospital were enrolled in the study. Thyroid function, morning serum ACTH and cortisol levels, thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), body composition, and metabolic indicators, including liver function and the lipid profile, were measured at the first visit. Statistical analysis was performed using SPSS version 21.0 (IBM, USA).

RESULTS: In total, 441 patients with overweight or obesity were enrolled (male/female, 123/318). Patients were assigned to four groups according to the thyroid-stimulating hormone (TSH) level stratified by quartiles, and increased body mass index (BMI) was revealed in the highest TSH quartile group (p=0.002). Hip circumference (HC) of patients in the highest TSH quartile group was significantly increased (p=0.021). Morning ACTH levels and fasting insulin levels were significantly elevated in patients in the highest TSH quartile group (p=0.027 for fasting insulin, p < 0.001 for ACTH). In the female subgroup, patients in the highest TSH quartile group showed increases in BMI (p=0.010), waist circumference (WC) (p=0.007), muscle mass of the lower extremities (p=0.020), fasting C-peptide (p=0.031), and ACTH (p=0.002). In the male subgroup, patients in the highest TSH quartile group exhibited higher BMI (p=0.017), HC (p=0.036), and ACTH (p=0.003). Among patients in the highest ACTH quartile group, there was an elevated proportion of males (p=0.003), and FT3 (p=0.005), fasting insulin (p=0.037), and cortisol (p < 0.001) levels were increased. Weight (p < 0.001), BMI (p < 0.001), WC (p < 0.001), HC (p < 0.001), muscle mass of the upper extremities (p=0.003), muscle mass of the lower extremities (p=0.005), and total muscle mass (p=0.003) were elevated in patients in the highest ACTH quartile group. HC was found to be an independent factor after adjustment for other confounders and was positively associated with the TSH level (p=0.004 for the regression model, B = 0.152, p=0.004).

CONCLUSIONS: BMI is positively correlated with TSH and ACTH levels in both male and female obese individuals. The ACTH level was positively associated with male sex and increased BMI and muscle mass. Hip circumference was an independent factor that was positively related to TSH levels.

PMID:35311031 | PMC:PMC8930244 | DOI:10.1155/2022/3830380

Int J Endocrinol. 2022 Mar 8;2022:2705650. doi: 10.1155/2022/2705650. eCollection 2022.

ABSTRACT

INTRODUCTION: Thyroid-associated ophthalmopathy (TAO) is the most common orbital immunological disease in adults. T cells play an important role in the pathogenesis of TAO. However, our knowledge of the circulating T cell subsets in TAO is limited.

OBJECTIVE: To investigate the circulating T cell subsets in TAO and the correlations between them and the activity of TAO.

METHODS: Thirty-eight TAO patients (19 active and 19 nonactive) were enrolled. The absolute number and percentage of total lymphocytes, CD3+T cells, CD4+T cells, CD8+ T cells, CD3+CD4-CD8-T cells (DNT cells), and CD3+CD4+CD8+ T cells (DPT cells) in peripheral blood were measured by flow cytometer.

RESULTS: TAO patients were divided into the active group and the nonactive group by the clinical activity score (CAS). The mean CAS was 4 ± 1.11 in the active group and 1.47 ± 0.61 in the nonactive group. No statistical differences were found in gender, age, and the levels of FT3, FT4, TSH, and TRAb between the two groups. The percentage of DNT cells was lower in the active group than in the non-active group, and it was negatively correlated with CAS (r = -0.349, P=0.032), but not the absolute number. The CD4/CD8 ratio, the absolute number and percentage of CD3+ T cells, CD4+ T cells, CD8+ T cells, and DPT cells did not differ between the two groups.

CONCLUSION: In the present study, we found the percentage of DNT cells was significantly lesser in the active TAO than in the nonactive TAO, and it was negatively correlated with the activity of the TAO. It suggests that DNT cells may involve in the immunopathogenesis of TAO and can serve as a clinical biomarker of the disease activity.

PMID:35311030 | PMC:PMC8924605 | DOI:10.1155/2022/2705650

J Product Anal. 2022 Mar 11:1-16. doi: 10.1007/s11123-022-00633-4. Online ahead of print.

ABSTRACT

This paper investigates the efficiency of Italian hospitals and how their performances have changed over the years 2007-2016, characterized by the great economic recession and budget constraints. We apply the Benefit of Doubt (BoD) approach to determine a composite index that considers the multi-dimensionality of the hospital outcome to be used as main output in a metafrontier production function based on a stochastic frontier framework. The efficiency score distribution is then used to construct a Theil index in order to compare, over time, the inequality of the estimated efficiency between hospitals, both within and between regions. The main findings show that the primary source of inefficiency comes from managerial inefficiency especially for hospitals located in southern regions. A clear and persistent North-South gap in efficiency performances of hospitals has been found along with an increase in the inequality in terms of efficiency between the areas of the country mostly determined by between region inequality.

PMID:35311015 | PMC:PMC8916485 | DOI:10.1007/s11123-022-00633-4

Front Cardiovasc Med. 2022 Mar 2;9:799488. doi: 10.3389/fcvm.2022.799488. eCollection 2022.

ABSTRACT

OBJECTIVES: Veno-arterial extracorporeal membrane oxygenation (ECMO) is increasingly used to treat high-risk pulmonary embolism (PE). However, its efficacy and safety remain uncertain. This retrospective cohort study aimed to determine whether ECMO could improve the clinical outcomes of patients with high-risk PE.

METHODS: Forty patients with high-risk PE, who were admitted to Kaohsiung Chang Gung Memorial Hospital between January 2012 and December 2019, were included in this study. Demographic data and clinical outcomes were compared between patients treated without ECMO (non-ECMO group) and those treated with ECMO (ECMO group). Appropriate statistical tools were used to compare variables between groups and the survival was analyzed using the Kaplan-Meier method.

RESULTS: The overall in-hospital mortality rate was 55%, in which 65% (26/40) of patients presented with cardiac arrest with a mortality rate of 77%, which was higher than that of patients without cardiac arrest (14%). There was no significant difference in major complications and in-hospital mortality between the non-ECMO and ECMO groups. However, in subgroup analysis, compared with patients treated without ECMO, earlier ECMO treatment was associated with a reduced risk of cardiac arrest (P = 0.023) and lower in-hospital mortality (P = 0.036). A log-rank test showed a significantly higher cumulative overall survival in the earlier ECMO treatment group (P = 0.033).

CONCLUSIONS: In this retrospective cohort study, earlier ECMO treatment was associated with lower in-hospital mortality among unstable patients without cardiac arrest. Our findings suggest that ECMO can be considered as an initial treatment option for patients with high-risk PE in higher-volume hospitals.

PMID:35310966 | PMC:PMC8924067 | DOI:10.3389/fcvm.2022.799488

Plant Genome. 2022 Mar 20:e20200. doi: 10.1002/tpg2.20200. Online ahead of print.

ABSTRACT

The ability to accurately quantify the simultaneous effect of multiple genomic loci on multiple traits is now possible due to current and emerging high-throughput genotyping and phenotyping technologies. To date, most efforts to quantify these genotype-to-phenotype relationships have focused on either multi-trait models that test a single marker at a time or multi-locus models that quantify associations with a single trait. Therefore, the purpose of this study was to compare the performance of a multi-trait, multi-locus stepwise (MSTEP) model selection procedure we developed to (a) a commonly used multi-trait single-locus model and (b) a univariate multi-locus model. We used real marker data in maize (Zea mays L.) and soybean (Glycine max L.) to simulate multiple traits controlled by various combinations of pleiotropic and nonpleiotropic quantitative trait nucleotides (QTNs). In general, we found that both multi-trait models outperformed the univariate multi-locus model, especially when analyzing a trait of low heritability. For traits controlled by either a combination of pleiotropic and nonpleiotropic QTNs or a large number of QTNs (i.e., 50), our MSTEP model often outperformed at least one of the two alternative models. When applied to the analysis of two tocochromanol-related traits in maize grain, MSTEP identified the same peak-associated marker that has been reported in a previous study. We therefore conclude that MSTEP is a useful addition to the suite of statistical models that are commonly used to gain insight into the genetic architecture of agronomically important traits.

PMID:35307964 | DOI:10.1002/tpg2.20200

Cancer Med. 2022 Mar 20. doi: 10.1002/cam4.4665. Online ahead of print.

ABSTRACT

OBJECTIVE: Currently, there is no standard adjuvant treatment protocol for localized uterine leiomyosarcoma (uLMS) as clinical trials to address this question have been retrospective, underpowered, or undermined by slow accrual rates. The aim of this study is to determine the benefit of adjuvant chemotherapy for uLMS.

METHODS: We reviewed the medical records of localized uLMS patients who had underwent adjuvant therapy after upfront surgery between 2000 and 2020. The cases were blinded for review. We evaluated the influence of various clinical characteristics and different types of adjuvant therapies on specific outcomes.

RESULTS: Sixty-eight patients (median age: 50 years) were included for analysis. Forty of 68 (58.8%) patients received adjuvant chemotherapy +/- radiation therapy and 25 patients (38.6%) did not receive any adjuvant therapy. At a median follow-up time of 43.3 months, 45 patients (66.1%) had relapsed disease. The median disease-free survival (mDFS) for all patients was 23.1 months. Patients who received any adjuvant treatment (chemotherapy and/or radiation) trended toward a longer mDFS compared with those who did not receive any adjuvant therapy (29.7 vs. 14.1 months, p = 0.26). Patients who received adjuvant chemotherapy alone had a longer, but nonstatistically significant mDFS compared with those who did not receive any adjuvant treatment (22.2 vs. 14.1 months, p = 0.18). Additionally, univariate analysis found that tumor size large than 10 cm, and a mitotic rate >10/10hpf were independent prognostic factors for worse DFS.

CONCLUSIONS: Though DFS was more favorable among those who received adjuvant therapy, it was not statistically significant, and thus based on this data adjuvant therapy for resected uLMS is still in question.

PMID:35307963 | DOI:10.1002/cam4.4665

Psych J. 2022 Mar 20. doi: 10.1002/pchj.536. Online ahead of print.

ABSTRACT

This study aimed to examine the relationship between gender, anxiety, mindfulness, and theory of mind (ToM). It was also aimed to investigate the mediating role of mindfulness in the relationship between anxiety and ToM. Additionally, the moderating role of gender in the relevant relationships was examined. The sample consisted of 323 people, including 260 (80.5%) females and 63 (19.5%) males, aged between 18-62 years. Data were collected by the Reading the Mind in the Eyes Test, the State-Trait Anxiety Inventory II, and the Mindful Attention Awareness Scale. It was found that ToM and anxiety levels were statistically significantly higher in women than men. In the regression analysis, it was detected that mindfulness predicts the 7% variance in ToM. The second predictor of ToM was found as anxiety, and both predictors explained the 9% variance in ToM. In the mediating analysis, it was found that mindfulness has a mediating role in the relationship between anxiety and ToM. In the moderated mediation analysis, it was determined that the pathway between anxiety and ToM was moderated by gender; the moderating role of gender also was found between mindfulness and ToM. In light of these findings, experimental future studies can be suggested with clinical samples for a better understanding of the relationships between gender, anxiety, mindfulness, and ToM.

PMID:35307962 | DOI:10.1002/pchj.536

Intern Med J. 2022 Mar;52(3):474-478. doi: 10.1111/imj.15712.

ABSTRACT

Admitting male and female patients to the same room compromises the safety of female patients and violates the rights of all patients. We demonstrate that mixed bedding is common (47.22% of admissions), increasing and disproportionately affects vulnerable older patients in a large New Zealand hospital from 2011 to 2019 (n = 160 048). Eliminating mixed bedding should be a priority for our hospital system.

PMID:35307925 | DOI:10.1111/imj.15712