Nevin Manimala

Ann Surg Oncol. 2021 Oct 30. doi: 10.1245/s10434-021-10945-8. Online ahead of print.

ABSTRACT

PURPOSE: Appendiceal cancer is a rare disease process with complex treatment strategies. The objective of this study was to identify mutation-based genetic subtypes that may differ from the current histological classification, compare the genetic make-up of primaries and metastases, and find novel targetable alterations.

METHODS: The analyses involved the curation and normalization of gene mutation panels from appendiceal adenocarcinoma and mucinous adenocarcinoma (n = 196) stored in the AACR GENIE Database v6.0. Genes mutated in less than one patient and tumors profiled with incomplete mutation panels were excluded from the study. The optimal number of AC subtypes was established using the Nonnegative Matrix Factorization algorithm. Statistical comparisons of mutation frequencies were performed using Pearson’s χ² test.

RESULTS: AC patients were stratified into five mutation subtypes, based on a final set of 41 cancer-related genes. AC0 had no mutations. The most frequently mutated genes varied between the subtypes were: AC1: KRAS (91.9%) and GNAS (77.4%); AC2: KRAS (52.5%), APC (32.5%), and GNAS (30%); AC3: KMT2D (38.7%), TP53 (38.7%), KRAS (35.5%), EP300 (22.6%); and AC4: TP53 (97.2%), KRAS (77.8%), and SMAD4 (36.1%). Additionally, AC3 was less likely to be mucinous (22.6% vs. 50.0-74.2%, p < 0.001) and had a higher mutation frequency (3.6 vs. 0-3.1, p < 0.001). There were no significant differences between primary tumors and metastases in the 41 assessed genes (p = 0.35).

CONCLUSIONS: The characterization of these subtypes suggests a need for molecular approaches to complement anatomical and histopathological staging for AC. A prospective comparison of subtype prognosis and response to surgery and adjuvant treatment is needed to identify the clinical applications of the novel molecular subtypes.

PMID:34718915 | DOI:10.1245/s10434-021-10945-8

Environ Monit Assess. 2021 Oct 30;193(11):757. doi: 10.1007/s10661-021-09554-5.

ABSTRACT

Taihu Lake Basin is highly developed but suffers from perennial water shortages due to pollution. Most studies have been limited to examining the water quality in specific areas, but few have investigated the entire basin. This study was based on official water quality data obtained from 565 sites in the monitoring network, thereby covering the entire basin. The water quality spatiotemporal variations were explored by statistical analysis, and the precise spatial distribution of the main pollutants was analyzed by heat maps. Only 29.09% of the water quality assessment results showed “drinkable,” whereas 28.63% showed “moderate” and “severe” pollution. The “severe” proportion had a significant declining trend (R² = 0.933) and was affected by the variations of nitrogen that was related to rainfall and anthropogenic activities. The water quality spatial variation was most likely related to anthropogenic influence and land use. The water quality in the developed and densely populated urban areas was poor, especially in downtown Shanghai. NH₃-N, TN, TP, BOD₅, COD, COD_Mn, and DO were the main pollutants that affected the water quality. NH₃-N and TN were major reduction targets. NH₃-N was the main pollutant that deteriorated the water quality in most densely populated urban areas. Many lakes and reservoirs were highly polluted with TN. Controlling domestic sewage may be effective to improve the water quality. This study makes up for the limited research on the water quality spatiotemporal variations in the entire Taihu Lake Basin and provides beneficial information and suggestions for decision-making regarding the water management.

PMID:34718911 | DOI:10.1007/s10661-021-09554-5

J Patient Rep Outcomes. 2021 Oct 30;5(1):113. doi: 10.1186/s41687-021-00394-y.

ABSTRACT

BACKGROUND: English versions of the University of Washington Caregiver Stress (UW-CSS) and Benefit (UW-CBS) Scales were developed in the United States (US) to measure impact on caregivers of caring for a child/children. Caregiving stress and benefit are important constructs to study worldwide. The purpose of this study was to translate and validate the UW-CSS and UW-CBS into French, German, Italian, and Spanish languages.

METHOD: UW-CSS and UW-CBS were translated using forward and backward translation with reconciliation. Cognitive interviews (CIs) were completed with caregivers of children < 18 years with severe epilepsy. Translated versions were also administered to at least 100 caregivers in each of the four countries: France, Germany, Italy, and Spain. Differential item functioning (DIF) analyses were used to assess linguistic and cultural bias by country. The US development sample of 722 caregivers was used as a comparison sample for DIF analyses. DIF adjusted scores were calculated to determine impact of DIF on the item response theory (IRT)-based T-score. Benefit and stress scores were also calculated and compared across countries and health condition subgroups. Finally, short forms were modified to minimize the impact of DIF on the UW-CSS and UW-CBS T-scores and to reflect feedback from CIs.

RESULTS: Interviews were completed with 47 caregivers (German n = 14; Spanish n = 10; French n = 13; Italian n = 10). UW-CSS and UW-CBS were administered to 456 (German n = 117, Spanish n = 114, French n = 115, Italian n = 110) caregivers of children with and without health conditions. All stress items functioned well in CIs, though results indicated statistically significant DIF for three items in multiple countries and in the overall sample. Four of the 13 benefit items were problematic based on CI feedback, and six items showed DIF in one or more countries or in the combined sample. However, average differences between DIF adjusted and non-adjusted scores were minimal for both scales and all comparisons, indicating the impact of DIF on the total score was negligible.

CONCLUSION: Modified short forms functioned well in all four of the translated versions. All language versions are freely publicly available.

PMID:34718901 | DOI:10.1186/s41687-021-00394-y

Seizure. 2021 Oct 20;93:81-87. doi: 10.1016/j.seizure.2021.10.009. Online ahead of print.

ABSTRACT

Since early 2020, an unprecedented public global health emergency caused by coronavirus (COVID-19) resulted in national governments’ imposing confinement measures. Lockdowns and isolation during pandemics complicate disease management and medication adherence. Chronic conditions, such as epilepsy, require linear adherence patterns to prevent breakthrough seizures and to reduce the risk of sudden unexpected death. Limited access to health care facilities for routine care and medicines management further hampers this. Social isolation exacerbates stress, depression and decreases social support, which may combine to reduce adherence to antiseizure medication (ASM) during the pandemic.

METHODS: We conducted a literature scoping review to explore ASM adherence among people with epilepsy, non-infected or infected SARS-CoV-2 or recovered from COVID-19 during the pandemic and explore risk factors for adherence. We search Pubmed for articles up to 16 September 2021. Search terms included the thematic of ASM adherence and COVID-19. We adhered to the PRISMA guidelines for reporting scoping reviews.

RESULTS: Six articles were retained after the screening, which covered four overarching themes: change of ASM compliance and as risk factors, lack of follow-up, difficulties accessing ASM, and behavioural risk factors. Our review underscores the lack of evidence on ASM adherence among people with epilepsy infected or recovered from COVID-19. No study retrieved took place in a low-income setting, warranting a cautionary approach to be employed when extrapolating findings on a global scale.

RECOMMENDATIONS FOR PRACTICE: Missing information on past SARS-CoV2 infections impact people with epilepsy precludes exploring a direct effect of SARS-CoV2 on ASM adherence. A more comprehensive chronic disease model based on the burden of co-cardiovascular and neuro-behavioural comorbidities should be envisaged for this population in preparation for future pandemics. A monitoring algorithm needs to be in place to establish a telemedicine framework and community pharmacists’ potential to contribute to the model recognised.

PMID:34717290 | DOI:10.1016/j.seizure.2021.10.009

Int J Nurs Stud. 2021 Sep 8;124:104088. doi: 10.1016/j.ijnurstu.2021.104088. Online ahead of print.

ABSTRACT

BACKGROUND: Food fortification as part of the food-first approach in nursing homes is a strategy that may increase energy and protein intake.

OBJECTIVES: This review aimed to determine the effect of nutrition interventions using fortification, nutrient-dense or enriched food and/or drinks on energy and protein intake in residents living in nursing homes, compared to the standard menu with or without oral nutritional support products. The secondary aim was to identify and synthesise outcomes of these interventions on weight change, nutritional status, acceptability, cost-effectiveness, and cost-benefit.

METHODS: A systematic search of seven databases was undertaken. After reviewing all titles/abstracts then full-text papers, key data were extracted and synthesised narratively and through meta-analysis. The quality of included studies was assessed using the Quality Criteria Checklist for Primary Research.

RESULTS: Of 3,098 articles retrieved, 16 were included, 13 in the meta-analysis. There were 891 participants, with the study duration ranging from four to 26 weeks. The groups receiving the fortified diet had a significantly higher energy intake (Hedges’ g = 0.69 (CI 0.36-1.03), p < 0.0001) and protein intake (Hedges’ g = 0.46 (CI 0.17-0.74), p = 0.003) compared with the groups receiving the standard menu +/- ONS. The meta-analysis revealed I² values of 77% for energy (p < 0.0001) and 60% for protein (p = 0.003), indicating considerable statistical heterogeneity across included studies. Benefits to weight and nutritional status of residents were recorded in some studies. Where reported, cost-effectiveness and cost-benefit of menu fortification/supplementation were variable.

CONCLUSIONS: This systematic review with meta-analyses has shown that fortified menus may significantly increase energy and protein intakes compared with standard menus in nursing homes. As such, the findings of this review support further use of fortified diets in this setting. Further research is warranted comparing food fortification to standard menus, with a particular focus on evaluating the effect on weight, nutritional status and cost-effectiveness of the intervention.

STUDY REGISTRATION: PROSPERO no. CRD42020162796.

PMID:34717275 | DOI:10.1016/j.ijnurstu.2021.104088

Int J Drug Policy. 2021 Oct 26;100:103491. doi: 10.1016/j.drugpo.2021.103491. Online ahead of print.

ABSTRACT

BACKGROUND: We investigated the importance of indicators of parental socio-economic status (SES) for getting an official drug charge, while we controlled for self-reported drug law infractions (use of illegal drugs and/or drug trafficking) and potential variables confounding the association.

METHODS: We used data from the long-term, population based longitudinal Young in Norway Study (N = 2,549). Participants were followed up over four survey-based data collections with linkages to crime registers from adolescence to adulthood. Data on drug charges were assessed based on official registers. The use of illegal substances, involvement with drug trafficking and potential covariates such as involvement with other types of crime, academic resources, and risk factors in the family, were assessed by means of self-reports.

RESULTS: Two per cent had been charged for drug-related offences, and 37% reported drug offending. Use of cannabis was the primary infraction statistically related to a criminal charge. Having parents with 4+ years university education (14% of the sample) was associated with lower risk for being charged than having parents with no higher education (OR 4.87; 95% CI: 1.16-20.52) or with a short university education (OR 4.76; 1.05-21.48). The association between parental education and drug charges remained stable when controlling for self-reported drug law infractions and other potential covariates.

CONCLUSION: In Norway, adolescents who have parents with higher university education, may be protected from getting a drug charge, even though they report similar levels of drug law infractions as other adolescents.

PMID:34717258 | DOI:10.1016/j.drugpo.2021.103491

Cognition. 2021 Oct 27;218:104939. doi: 10.1016/j.cognition.2021.104939. Online ahead of print.

ABSTRACT

How people update their beliefs when faced with new information is integral to everyday life. A sizeable body of literature suggests that people’s belief updating is optimistically biased, such that their beliefs are updated more in response to good news than bad news. However, recent research demonstrates that findings previously interpreted as evidence of optimistic belief updating may be the result of flaws in experimental design, rather than motivated reasoning. In light of this controversy, we conduct three pre-registered variations of the standard belief updating paradigm (combined N = 300) in which we test for asymmetric belief updating with neutral, non-valenced stimuli using analytic approaches found in previous research. We find evidence of seemingly biased belief updating with neutral stimuli – results that cannot be attributed to a motivational, valence-based, optimism account – and further show that there is uninterpretable variability across samples and analytic techniques. Jointly, these results serve to highlight the methodological flaws in current optimistic belief updating research.

PMID:34717257 | DOI:10.1016/j.cognition.2021.104939

Epilepsy Behav. 2021 Oct 27;124:108357. doi: 10.1016/j.yebeh.2021.108357. Online ahead of print.

ABSTRACT

By assessing the cognitive capital, neuropsychological evaluation (NPE) plays a vital role in the perioperative workup of patients with refractory focal epilepsy. In this retrospective study, we used cutting-edge statistical approaches to examine a group of 47 patients with refractory temporal lobe epilepsy (TLE), who underwent standard anterior temporal lobectomy (ATL). Our objective was to determine whether NPE may represent a robust predictor of the postoperative status, two years after surgery. Specifically, based on pre- and postsurgical neuropsychological data, we estimated the sensitivity of cognitive indicators to predict and to disentangle phenotypes associated with more or less favorable outcomes. Engel (ENG) scores were used to assess clinical outcome, and picture naming (NAM) performance to estimate naming status. Two methods were applied: (a) machine learning (ML) to explore cognitive sensitivity to postoperative outcomes; and (b) graph theory (GT) to assess network properties reflecting favorable vs. less favorable phenotypes after surgery. Specific neuropsychological indices assessing language, memory, and executive functions can globally predict outcomes. Interestingly, preoperative cognitive networks associated with poor postsurgical outcome already exhibit an atypical, highly modular and less densely interconnected configuration. We provide statistical and clinical tools to anticipate the condition after surgery and achieve a more personalized clinical management. Our results also shed light on possible mechanisms put in place for cognitive adaptation after acute injury of central nervous system in relation with surgery.

PMID:34717247 | DOI:10.1016/j.yebeh.2021.108357

Arch Gerontol Geriatr. 2021 Oct 13;98:104558. doi: 10.1016/j.archger.2021.104558. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to identify the mental health problems and quality of life of family caregivers of people with dementia, depending on whether they live with people with dementia.

METHODS: The sample was divided into three groups: those without a family member with dementia, those with a family member with dementia but not living with them, and those living with a family member with dementia. Descriptive statistics, ANCOVA, and post-hoc tests were performed on key variables. We included a total of 324,078 people with at least one family member older than 60 years, whose data were extracted from the Korean Community Health Survey. Dependent variables: depressive symptoms, stress recognition, subjective health, happiness, and quality of life.

INDEPENDENT VARIABLES: family member with dementia (yes/no), cohabitation type. Control variables: Sex, age, region (urban/rural), household income, and education level.

RESULTS: Depressive symptoms and stress recognition were higher in people who live with a family member with dementia. Their subjective health, happiness, and quality of life were the lowest of the three groups. Overall, the indicators for people who lived with a family member with dementia were the most negative, followed by those who did not live with their family member with dementia, and then those who did not have such a family member.

CONCLUSIONS: Family caregivers living with people with dementia must be prioritized in policies regarding dementia; a program that can provide emotional support and reduce the burden of care is needed.

PMID:34717241 | DOI:10.1016/j.archger.2021.104558

Comput Biol Med. 2021 Oct 25;139:104973. doi: 10.1016/j.compbiomed.2021.104973. Online ahead of print.

ABSTRACT

The automatic identification of mosquito genus, if used together with effective strategies of suppression and control may help reduce the spread of mosquito-borne diseases. In this study, we explored and developed a simple and yet very effective algorithm for processing audio files to determine the presence (or absence) of a mosquito and then identify the correct genus for those involving a mosquito. A dataset of sound recordings from the Humbug Project of Zooniverse, collected by researchers from Oxford University, and actual recordings of mosquitoes in the Philippines were used in this study. Our developed technique involves extracting filter bank values from corresponding spectrograms of the audio files, and we built a classification model based only on three simple statistics from said collected values — maximum, first quartile and third quartile. Specifically, the maximum values were used in defining thresholds for the candidate-elimination phase of the algorithm, and then the first and third quartile values were used in the succeeding nearest centroid computation phase. The proposed algorithm yielded an impressive 97.2% average classification accuracy from a 5-fold stratified cross validation. This is competitive with the 75.55-97.65% accuracy results reported in literature for different mosquito classification tasks run on different datasets. Moreover, the achieved accuracy is significantly higher than the 86.6% that we gathered from applying a CNN architecture from literature to our same dataset. Aside from being more accurate, the proposed algorithm is also significantly more efficient than the CNN model, requiring much less time (in both training and predicting phases) and memory space. The results offer a promising technique that may also simplify the process of solving other sound-based classification problems.

PMID:34717231 | DOI:10.1016/j.compbiomed.2021.104973