Nevin Manimala

J Bone Miner Res. 2022 Jul 10. doi: 10.1002/jbmr.4646. Online ahead of print.

ABSTRACT

Recent experimental work has identified CXCL9 as a promoter for the differentiation of osteoclast progenitors into osteoclasts, with resultant bone resorption. However, no human study has validated an association between this chemokine and osteoporosis or fracture risk. We conducted a matched case-control study nested in the prospective, population-based Singapore Chinese Health Study. Fifty-five men and 119 women with incident hip fractures, occurring median 6.2 years after blood collection, were matched individually to controls by age at recruitment, gender and duration of blood storage. Serum chemokines, CXCL9 and CXCL10, were measured using immunoassays. Multivariable conditional logistic regression models that included age at blood collection, body mass index, smoking and diabetes as covariates were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for association with hip fracture risk. Predictive utility of chemokine for hip fracture risk was examined by comparing area under receiver operating characteristic curves (AUC) between prognostic models with and without the chemokine. Increasing CXCL9 levels were associated with increasing hip fracture risk in men but not in women (P_interaction =0.002). Comparing extreme quartiles, the OR (95% CI) in the highest quartile was 10.35 (1.90-56.39) in men (P_trend =0.002) and 1.46 (0.59-3.60) in women (P_trend =0.32). Adding CXCL9 to a prognostic model that already incorporated age and other risk factors improved the AUC (95% CI) from 0.65 (0.55-0.76) to 0.74 (0.65-0.83) for the predictive utility of hip fractures in men but not in women. Conversely, the association between CXCL10 and hip fracture risk was not statistically significant in either gender. This article is protected by copyright. All rights reserved.

PMID:35810382 | DOI:10.1002/jbmr.4646

ARP Rheumatol. 2022 Apr-Jun;1(2):109-116.

ABSTRACT

OBJECTIVE: To compare the effectiveness and safety of original (Enbrel®) and biosimilar (Benepali®) etanercept in Biologic Disease-modifying Antirheumatic Drug (bDMARD)-naïve patients, measured by persistence rates over 36 months of follow-up.

METHODS: A retrospective multicentre observational study using data collected prospectively from The Rheumatic Diseases Portuguese Registry (Reuma.pt) was performed, including patients with: age ≥ 18 years old; diagnosis of Rheumatoid Arthritis (RA), Psoriatic Arthritis (PsA) or Spondyloarthritis (SpA) (axial or peripheral) with active disease and biologic-naïve who initiated treatment with etanercept as the first line biological treatment after 2010. Kaplan-Meyer and Cox regression were used to calculate the persistence rate in treatment. Disease activity at baseline and follow-up data at 6, 12, 18 and 24 months of treatment were compared. Causes for discontinuing therapy were summarized using descriptive statistics. Statistical significance was assumed for 2-sided p-values <0.05.

RESULTS: We included 1693 patients (413 on Benepali® and 1280 on Enbrel®): 864 diagnosed with RA, 335 with PsA and 494 with SpA. The 3-year persistence rates were not significantly different between both treatment groups in RA, PsA and SpA patients. In the adjusted Cox model, hazard ratios of discontinuation were not statistically different (p>0.05). The proportion of subjects in remission or low disease activity in each disease was similar in both groups. Overall, 535 (31.6%) patients discontinued etanercept (428 patients on Enbrel® and 107 patients on Benepali®). The major cause of discontinuation was inefficacy (57.8%). No differences for the occurrence of inefficacy or adverse effects were found between treatment groups.

CONCLUSIONS: Benepali® and Enbrel® demonstrated similar effectiveness and safety in RA, PsA and SpA in our cohort of patients. These data corroborate that the original and biosimilar drugs have similar quality characteristics and biological activity.

PMID:35810368

Ann Parasitol. 2022;68(2):305-316. doi: 10.17420/ap6802.436.

ABSTRACT

Cutaneous leishmaniosis (CL) is one of the most important known infectious skin diseases, and Iran, as a country at high risk of leishmaniosis. This research was carried out to describe the epidemiological status of cutaneous leishmaniosis during 2011-2018 years in Bushehr province. Total, 929 cutaneous leishmaniosis patients were registered in the Bushehr province during this period. Data analysis was carried out using IBM SPSS Statistics, version 22. The data were analyzed using the descriptive statistics, Chi-square test, and Fisher’s exact test. The highest frequency was related to the age group of 1-10 years (35.1%). The patients consist (60.4%) males and (39.6%) females. The highest and lowest rates of disease were found in 2011 (16.3%) and 2017 (6.6%), respectively, and in January (16.6%) and September (3.2%), respectively. In terms of the ulcer number, (51%) of the cases had one ulcer, and (23%) had (3-5) ulcers. Dry ulcers made up (68.2%) of ulcers, while the wet ulcers made up (31.8%). The hands had accounted for (37%) of ulcers, the face for (25%), and the feet for (21%). Age of cases was significantly associated with the number and site of ulcers (P<0.001). As well, there was a significant relationship between gender and the number of ulcers (P<0.035). This eight-year study confirmed that in Iran, Bushehr province is one of the endemic areas for the cutaneous leishmaniosis. The increase in the patients in 2018, despite its decrease in previous years, is an alert for coming years. Effective disease prevention, control, and treatment measures are essential. Furthermore, the children, who are a vulnerable population, need the special care and treatment.

PMID:35810363 | DOI:10.17420/ap6802.436

J Cosmet Dermatol. 2022 Jul 10. doi: 10.1111/jocd.15223. Online ahead of print.

ABSTRACT

BACKGROUND: Common skin conditions, such as irritated, dry, aging and oily skin or dark eye circles with periorbital edema, usually do not require pharmaceutical therapy in form of dermatological drugs. They can, however, still affect the quality of life significantly. With the advent of newer cosmetics, a more targeted treatment of these dermatological conditions has become available to the public. There are few clinical studies investigating the efficacy and safety of cosmetics, leaving consumers exposed to potentially false claims of the cosmetic industry. This study aims to assess the efficacy and safety of a novel skin care series addressing the aforementioned five common skin conditions.

METHODS: This open-label, single-center, 4-week, prospective clinical study evaluated the efficacy and safety of five novel skin care formulations, each targeting one of five common skin issues in 176 study subjects. The primary endpoint parameters for the change of irritated skin, dark and puffy eyes, dry skin, aging skin and oily skin were assessed through validated questionnaires, scales and biomedical devices.

RESULTS: After four weeks of topical application of each formulation of a new targeted skin care, a significant improvement in all primary endpoints was detected. No undesirable effects occurred during this study.

CONCLUSION: This study showed a significant improvement of five common dermatological conditions with a novel targeted skin care series. Moreover, this study leads the way for an overdue critical assessment and certification of cosmetic product claims.

PMID:35810352 | DOI:10.1111/jocd.15223

Nurs Forum. 2022 Jul 10. doi: 10.1111/nuf.12778. Online ahead of print.

ABSTRACT

INTRODUCTION: Professional values give meaning and direction to clinical practices by providing a philosophical framework for nursing practices. The internalization of professional values is quite effective in providing professional service and is very important in terms of service quality.

DESIGN: This descriptive study has been conducted to determine the relationship between nurses’ professional values and caring behaviors.

METHODS: A total of 176 nurses participated who worked in hospitals in this study. The data were collected online using the Nurse Information Form, Nurses Professional Values Scale-Revised (NPVS-R), and Caring Behaviors Assessment Tool Nursing Version-Short Form (CBAN-SF). Data analysis was performed using SPSS software, the Mann-Whitney U test, the Kruskall-Wallis test, and the Spearman correlation coefficient.

RESULTS: Of the nurses participating in the study, 66.5% are between the ages of 21-30, 80.7% are female, and 71% are university graduates. No statistically significant difference was found regarding professional values between the mean scores from the NPVS-R and CBAN-SF in terms of the nurses’ age, gender, position, working style, clinic at which they work, or their educational status. The nurses scored high on the NPVS-R and CBAN. A moderate, significant, and positive relationship was found between nurses’ overall scores on the NPVS-R and CBAN-SF.

CONCLUSION: As nurses’ perceptions of professional values increase, their perception toward assessing care behaviors also increases. In addition, a relationship exists between nurses’ education levels and assessment of care behaviors and between their work experience and their perceptions of professional values. Conducting studies on the subject using different designs is recommended.

PMID:35810340 | DOI:10.1111/nuf.12778

Biophys J. 2022 Jul 8:S0006-3495(22)00557-4. doi: 10.1016/j.bpj.2022.07.011. Online ahead of print.

ABSTRACT

Transcription factor (TF) binding to genomic DNA elements constitutes one of the key mechanisms that regulates gene expression program in cells. Both consensus and non-consensus DNA sequence elements influence the recognition specificity of TFs. Based on the analysis of experimentally determined c-Myc binding preferences to genomic DNA, here we statistically predict that certain repetitive, non-consensus DNA symmetry elements can relatively reduce TF-DNA binding preferences. This is in contrast to a different set of repetitive, non-consensus symmetry elements that can increase the strength of TF-DNA binding. Using c-Myc enhancer reporter system containing consensus motif flanked by non-consensus sequences in embryonic stem cells (ESCs), we directly demonstrate that the enrichment in such negatively regulating repetitive symmetry elements is sufficient to reduce the gene expression level as compared with native genomic sequences. Negatively regulating repetitive symmetry elements around consensus c-Myc motif and DNA sequences containing consensus c-Myc motif flanked by entirely randomized sequences show similar expression baseline. A possible explanation for this observation is that rather than complete repression, negatively regulating repetitive symmetry elements play a regulatory role in fine-tuning the reduction of gene expression, most probably by binding TFs other than c-Myc.

PMID:35810331 | DOI:10.1016/j.bpj.2022.07.011

BMC Geriatr. 2022 Jul 9;22(1):568. doi: 10.1186/s12877-022-03245-7.

ABSTRACT

OBJECTIVES: To investigate the relationship between diffusion tensor imaging (DTI) indicators and cerebral small vessel disease (CSVD) with depressive states, and to explore the underlying mechanisms of white matter damage in CSVD with depression.

METHOD: A total of 115 elderly subjects were consecutively recruited from the neurology clinic, including 36 CSVD patients with depressive state (CSVD+D), 34 CSVD patients without depressive state (CSVD-D), and 45 controls. A detailed neuropsychological assessment and multimodal magnetic resonance imaging (MRI) were performed. Based on tract-based spatial statistics (TBSS) analysis and structural network analysis, differences between groups were compared, including white matter fiber indicators (fractional anisotropy and mean diffusivity) and structural brain network indicators (global efficiency, local efficiency and network strength), in order to explore the differences and correlations of DTI parameters among the three groups.

RESULTS: There were no significant differences in terms of CSVD burden scores and conventional imaging findings between the CSVD-D and CSVD+D groups. Group differences were found in DTI indicators (p < 0.05), after adjusting for age, gender, education level, and vascular risk factors (VRF), there were significant correlations between TBSS analysis indicators and depression, including: fractional anisotropy (FA) (r = – 0.291, p < 0.05), mean diffusivity (MD) (r = 0.297, p < 0.05), at the same time, between structural network indicators and depression also show significant correlations, including: local efficiency (E_Local) (r = – 0.278, p < 0.01) and network strength (r = – 0.403, p < 0.001).

CONCLUSIONS: Changes in FA, MD values and structural network indicators in DTI parameters can predict the depressive state of CSVD to a certain extent, providing a more direct structural basis for the hypothesis of abnormal neural circuits in the pathogenesis of vascular-related depression. In addition, abnormal white matter alterations in subcortical neural circuits probably affect the microstructural function of brain connections, which may be a mechanism for the concomitant depressive symptoms in CSVD patients.

PMID:35810313 | DOI:10.1186/s12877-022-03245-7

J Transl Med. 2022 Jul 9;20(1):312. doi: 10.1186/s12967-022-03506-4.

ABSTRACT

BACKGROUND: The oral ecosystem conditions dental health, and is known to be positively modified by oral hygiene which cannot always be performed between meals, especially outside home. It is therefore important to identify the practices to be adopted to influence the oral environment in an anticariogenic direction. Milk and cheese are considered functional foods and have a role on oral health. There are several mechanisms by which cheese exerts its beneficial effects on teeth. The aim of the present study was to examine whether short term consumption of hard cheese would affect the oral pH and microbial flora of healthy adults modifying ecological oral environment. The Next Generation Sequencing (NGS) approach was applied to study the effect of Italian Grana Padano (GP), as a prototype of typical hard cheese, on the oral microbiota composition. Finally, we explored Streptococcus mutans/sanguinis ratio as a marker of protective biofilm composition.

METHODS: Nine oral-healthy adults were instructed to eat 25 gr of GP cheese for 5 consecutive days. Three time points were chosen for supragingival samples collection and pH measurement. 16S rRNA-gene sequences were obtained both from oral samples and GP cheese using the MiSeq platform and analyzed against the expanded Human Oral Microbiome Database (eHOMD). ProgPerm was used to perform statistical analyses to investigate strain differential representation after cheese consumption.

RESULTS: Taxonomic analyses of the oral microbiota revealed that Firmicutes was the most abundant phylum, followed by Proteobacteria and Actinobacteria. GP cheese significantly modifies oral pH, causing a shift toward basic conditions which are kept for a few hours. The Streptococcus mutans/Streptococcus sanguinis ratio lowers in the last observed timepoint.

CONCLUSION: Our results reveal that a portion of GP cheese eaten after dinner provides important micronutrients (i.e. calcium, vitamins and some aminoacids such as arginine) and changes oral pH toward basic conditions, resulting in a light modification of the oral microbiome towards the reduction of the overall amount of acidophilic bacteria. Furthermore, the S. mutans/S. sanguinis ratio is reduced, contributing to obtain a more protecting environment towards caries establishment and evolution.

PMID:35810305 | DOI:10.1186/s12967-022-03506-4

Health Qual Life Outcomes. 2022 Jul 9;20(1):106. doi: 10.1186/s12955-022-02013-w.

ABSTRACT

BACKGROUND: Due to limited capability to function in post-injury daily life injury, survivors need to be reliably assessed without need to commute more than necessary. The key action is to determine the level of functioning difficulties. Having the opportunity of conducting a national post-crash traffic safety and health cohort study, we aimed to translate into Persian and assess the psychometric properties of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) through phone surveys six month post injury.

METHODS: First, having World Health Organization permission, we tested the translation validity by forward translation, expert panel evaluation, back-translation, pre-testing and cognitive interviewing, and finalizing the Persian WHODAS. Then, through a psychometric study within a national cohort platform, the validity, reliability and applicability of the 12-item WHODAS was assessed through phone surveys. We included data of 255 road traffic injury patients enrolled from the cohort at six-month follow-up. The psychometric assessment (internal consistency reliability and stability reliability) was conducted on test-retest data of 50 patients with an average 7-day time span. An exploratory factor analysis tested the construct validity using extraction method of principal component factor and oblique rotation on data from 255 patients. Regarding the multiple criteria including an eigenvalue > 0.9, Cattell’s scree test, cumulative variance, and the theoretical basis, the minimum number of factors were retained. Data were analyzed using STATA statistical software package.

RESULTS: The respondents were mostly male (81%), employed (71%), educated (87%), and with a mean age of 37.7(14.9). The Persian version had high internal consistency reliability (Cronbach’s α = 0.93) and excellent stability reliability (ICC = 0.97, 95% CI: 0.92-0.98). An exploratory factor analysis retained four factors defining 86% of all the variance. Factors of Self-care, Mobility, and Cognition were completely retained.

CONCLUSIONS: The brief Pesrian WHODAS 2.0 was highly reliable and valid to be applied through phone interviews post injury.

PMID:35810300 | DOI:10.1186/s12955-022-02013-w

BMC Health Serv Res. 2022 Jul 10;22(1):895. doi: 10.1186/s12913-022-08300-y.

ABSTRACT

BACKGROUND: Ukraine is reforming its health care system to improve quality of health care. Insight into how primary health care managers perceive quality is important for the ongoing reform as well as for the improvement of medical services.

METHODS: An online survey was conducted as part of the Ukrainian-Swiss project “Medical Educational Development” in April-May 2019 based on the contact list of USAID project “Health Reform Support”, and additionally on the database of the National Health Service of Ukraine and other channels. Data were analyzed using descriptive statistics and qualitative data analysis.

RESULTS: In total, 302 health care managers took part in the study. The majority of primary health care managers perceive quality in health care as process quality. They associate quality mostly with compliance to standards. At the same time, primary health care managers prefer to assess outcome quality via a system of indicators and feedback. There appears to be a lack of consensus about health care quality. This may be due to a lack of awareness of the national strategy for better quality of health care service.

CONCLUSIONS: Our study provides new insights into primary care managers’ perceptions of health care quality in Ukraine. The absence of a clear consensus about quality complicates the discussion about quality and how to measure quality in health care. This appears to be one of the obstacles to system-wide quality improvement.

PMID:35810293 | DOI:10.1186/s12913-022-08300-y