Nevin Manimala

Rev Assoc Med Bras (1992). 2021 Jan;67(1):115-119. doi: 10.1590/1806-9282.67.01.20200584.

ABSTRACT

OBJECTIVE: We aimed to compare the clinical, epidemiological, and prognostic features of the H1N1 pandemic in 2009 and the severe acute respiratory syndrome coronavirus 2 pandemic in 2020.

METHODS: This retrospective study involved subjects from seven centers that were admitted and found to be positive for H1N1 or COVID-19 real-time polymerase chain reaction test.

RESULTS: A total of 143 patients with H1N1 and 309 patients with COVID-19 were involved in the study. H1N1 patients were younger than COVID-19 ones. While 58.7% of H1N1 patients were female, 57.9% of COVID-19 patients were male. Complaints of fever, cough, sputum, sore throat, myalgia, weakness, headache, and shortness of breath in H1N1 patients were statistically higher than in COVID-19 ones. The duration of symptoms until H1N1 patients were admitted to the hospital was shorter than that for COVID-19 patients. Leukopenia was more common in COVID-19 patients. C-reactive protein levels were higher in COVID-19 patients, while lactate dehydrogenase levels were higher in H1N1 ones. The mortality rate was also higher in H1N1 cases.

CONCLUSIONS: The severe acute respiratory syndrome coronavirus 2 pandemic is a major public health problem that continues to affect the world with its high rate of contagion. In addition, no vaccines or a specific drug for the benefit of millions of people have been found yet. The H1N1 pandemic is an epidemic that affected the whole world about ten years ago and was prevented by the development of vaccines at a short period. Experience in the H1N1 pandemic may be the guide to prevent the COVID-19 pandemic from a worse end.

PMID:34161484 | DOI:10.1590/1806-9282.67.01.20200584

Rev Assoc Med Bras (1992). 2021 Jan;67(1):39-44. doi: 10.1590/1806-9282.67.01.20200102.

ABSTRACT

OBJECTIVE: The aim of this retrospective study was to investigate the correlation of transiently elevated postoperative serum cancer antigen 125 levels and prognosis in patients with non-small cell lung cancer.

METHODS: A total of 181 non-small cell lung cancer patients with normal levels of preoperative serum cancer antigen 125 were statistically summarized in this study.

RESULTS: Out of the analyzed patients, 22 (12.2%) showed elevation of serum cancer antigen 125 within one month after surgery. Serum cancer antigen 125 level decreased to normal at three months postoperation. Serum cancer antigen 125 was positively correlated with pro-brain natriuretic peptide in non-small cell lung cancer postoperative patients (p=0.00035). Univariate analysis did not find significant difference in disease progression survival between those who experienced cancer antigen 125 elevation in the early postoperation and those who did not (p=0.646).

CONCLUSIONS: In conclusion, transient elevation of cancer antigen 125 is associated to pro-brain natriuretic peptide increase after pulmonary surgery in non-small cell lung cancer patients.

PMID:34161480 | DOI:10.1590/1806-9282.67.01.20200102

J Thromb Haemost. 2021 Jun 23. doi: 10.1111/jth.15430. Online ahead of print.

ABSTRACT

BACKGROUND: TFPI is an essential regulator of coagulation, limiting thrombin generation and preventing thrombosis. In humans and mice, TFPIα is the sole isoform present in platelets.

OBJECTIVE: Here we asked whether TFPIα, because of its release from platelets at sites of injury, has a unique role in limiting the hemostatic response.

METHODS: TFPIα-mutant (Tfpi^Δα/Δα ) mice were generated by introducing a stop codon in the C-terminus. Platelet accumulation, platelet activation, and fibrin accumulation were measured following penetrating injuries in the jugular vein and cremaster muscle arterioles, and imaged by fluorescence and scanning electron microscopy. Time to bleeding cessation was recorded in the jugular vein studies.

RESULTS: Tfpi^Δα/Δα mice were viable and fertile. Plasma TFPI levels were normal in the Tfpi^Δα/Δα mice, no TFPI protein or activity was present in their platelets and thrombin-antithrombin (TAT) complex levels were indistinguishable from Tfpi^+/+ littermates. There was a small, but statistically significant reduction in the time to bleeding cessation following jugular vein puncture injury in the Tfpi^Δα/Δα mice, but no measurable changes in platelet or fibrin accumulation or in hemostatic plug architecture following injury of the micro- or macrovasculature.

CONCLUSION: Loss of TFPIα expression does not produce a global prothrombotic state in mice. Platelet TFPIα is expected to be released or displayed in a focal manner at the site of injury, potentially accumulating to high concentrations in the narrow gaps between platelets. If so, the data from the vascular injury models studied here indicate this is not essential for a normal hemostatic response in mice.

PMID:34160126 | DOI:10.1111/jth.15430

J Magn Reson Imaging. 2021 Jun 23. doi: 10.1002/jmri.27793. Online ahead of print.

ABSTRACT

BACKGROUND: Multiparametric MRI (mpMRI) is commonly recommended as a triage test prior to any prostate biopsy. However, there exists limited consensus on which patients with a negative prostate mpMRI could avoid prostate biopsy.

PURPOSE: To identify which patient could safely avoid prostate biopsy when the prostate mpMRI is negative, via a radiomics-based machine learning approach.

STUDY TYPE: Retrospective.

SUBJECTS: Three hundred thirty patients with negative prostate 3T mpMRI between January 2016 and December 2018 were included.

FIELD STRENGTH/SEQUENCE: A 3.0 T/T2-weighted turbo spin echo (TSE) imaging (T₂ WI) and diffusion-weighted imaging (DWI).

ASSESSMENT: The integrative machine learning (iML) model was trained to predict negative prostate biopsy results, utilizing both radiomics and clinical features. The final study cohort comprised 330 consecutive patients with negative mpMRI (PI-RADS < 3) who underwent systematic transrectal ultrasound-guided (TRUS) or MR-ultrasound fusion (MRUS) biopsy within 6 months. A secondary analysis of biopsy naïve subcohort (n = 227) was also conducted.

STATISTICAL TESTS: The Mann-Whitney U test and Chi-Squared test were utilized to evaluate the significance of difference of clinical features between prostate biopsy positive and negative groups. The model performance was validated using leave-one-out cross-validation (LOOCV) and measured by AUC, sensitivity, specificity, and negative predictive value (NPV).

RESULTS: Overall, 306/330 (NPV 92.7%) of the final study cohort patients had negative biopsies, and 207/227 (NPV 91.2%) of the biopsy naïve subcohort patients had negative biopsies. Our iML model achieved NPVs of 98.3% and 98.0% for the study cohort and subcohort, respectively, superior to prostate-specific antigen density (PSAD)-based risk assessment with NPVs of 94.9% and 93.9%, respectively.

DATA CONCLUSION: The proposed iML model achieved high performance in predicting negative prostate biopsy results for patients with negative mpMRI. With improved NPVs, the proposed model can be used to stratify patients who in whom we might obviate biopsies, thus reducing the number of unnecessary biopsies.

EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 2.

PMID:34160114 | DOI:10.1002/jmri.27793

Plant J. 2021 Jun 23. doi: 10.1111/tpj.15384. Online ahead of print.

ABSTRACT

The photosynthetic capacity of mature leaves increases after several days’ exposure to constant or intermittent episodes of high light (HL) and is manifested primarily as changes in chloroplast physiology. How this chloroplast-level acclimation to HL is initiated and controlled is unknown. From expanded Arabidopsis leaves, we determined HL-dependent changes in transcript abundance of 3844 genes in a 0-6h time-series transcriptomics experiment. It was hypothesised that among such genes were those that contribute to the initiation of HL acclimation. By focussing on differentially expressed transcription (co-)factor (TF) genes and applying dynamic statistical modelling to the temporal transcriptomics data, a regulatory network of 47 predominantly photoreceptor-regulated (co)-TF genes was inferred. The most connected gene in this network was B-BOX DOMAIN CONTAINING PROTEIN32 (BBX32). Plants over-expressing BBX32 were strongly impaired in acclimation to HL and displayed perturbed expression of photosynthesis-associated genes under LL and after exposure to HL. These observations led to demonstrating that as well as regulation of chloroplast-level acclimation by BBX32, CRYPTOCHROME1, LONG HYPOCOTYL5, CONSTITUTIVELY PHOTOMORPHOGENIC1 and SUPPRESSOR OF PHYA-105 are also important. Additionally, the BBX32-centric gene regulatory network provides a view of the transcriptional control of acclimation in mature leaves distinct from other photoreceptor-regulated processes, such as seedling photomorphogenesis.

PMID:34160110 | DOI:10.1111/tpj.15384

Conserv Biol. 2021 Jun 23. doi: 10.1111/cobi.13800. Online ahead of print.

ABSTRACT

Community-level resource management efforts are cornerstones in ensuring sustainable use of natural resources. Yet, understanding how community characteristics influence management practises remains contested. This study used a large sample size (≥ 725 communities depending on analysis) of nationally collected data to assess the effects of key community characteristics (human population size and density, market integration and modernization) on the probability of occurrence of fisheries management practises including gear, species and spatial restrictions. The study was based in Solomon Islands, a Pacific Island country with a population that is highly dependent on coastal fisheries with people primarily dwelling in small communities adjacent to the coastline dispersed across six island provinces and numerous smaller islands. The relatively tight coupling of communities and adjacent fisheries resources provides a context amenable to testing theories of socioeconomic factors that explain occurrence of resource management. We present our results of binomial logistic regression models as the likelihood of management occurrence, given socioeconomic context. In contrast to prevailing views, we found a strong positive association between both human population size and market integration and the probability of occurrence across all three management practises. Human population density, however, had a dramatic negative association, and modernization a varied and limited association with occurrence of all management practises. Combined, these findings present significant opportunity for remotely predicting the occurrence of resource management practises based on key socioeconomic characteristics. The results also present opportunity for further research to understand why some communities conduct natural resource management activities when statistical patterns suggest they are not likely to, thus better understanding how some communities of people beat the odds despite adverse conditions. This article is protected by copyright. All rights reserved.

PMID:34160100 | DOI:10.1111/cobi.13800

Paediatr Perinat Epidemiol. 2021 Jun 23. doi: 10.1111/ppe.12782. Online ahead of print.

ABSTRACT

BACKGROUND: A better understanding of the overuse of antenatal care is needed to improve its organisation to deal with limited medical resources and doctor shortages.

OBJECTIVES: To assess the proportion of women who overuse antenatal care and the associations of overuse with maternal characteristics and the qualifications of healthcare providers.

METHODS: We used the 2016 National Perinatal Survey, a cross-sectional population-based survey, performed in all maternity units in France, including 13,132 women. Based on the French national guidelines, 6-8 antenatal visits were defined as adequate, 9-11 as high use, and ≥12 as overuse, while 3 ultrasounds were considered adequate, 4-5 as high use, and ≥6 as overuse. We performed binary modified Poisson regressions-with adequate care as the reference-including maternal social and medical characteristics and the healthcare professionals’ qualifications.

RESULTS: After women with inadequate care were excluded, 19.2% of low-risk women had at least 12 visits and 30.5% at least 6 ultrasounds. Overuse of visits was associated with primiparity, average to high income, less than good psychological well-being, and care by an obstetrician. The risks of overuse of ultrasounds were higher among primiparous, women with average to high income and those receiving care from a public-sector obstetrician (adjusted relative risk 1.17, 95% CI, 1.13, 1.21) or private obstetrician (adjusted relative risk 1.12, 95% CI, 1.07, 1.16), compared with a public-sector midwife.

CONCLUSIONS: Antenatal care overuse is very common in France and associated with some maternal characteristics and also the qualification of care provider. Antenatal care should be customised according to women’s needs, in particular for primiparae and those with poor well-being, and available medical resources.

PMID:34160099 | DOI:10.1111/ppe.12782

J Exp Biol. 2021 Jun 23:jeb.234567. doi: 10.1242/jeb.234567. Online ahead of print.

ABSTRACT

Previous studies in primates and other animals have shown that mass specific cost of transport (J kg-1 m-1) for climbing is independent of body size across species, but little is known about within-species allometry of climbing costs or the effects of difficulty and velocity. Here, we assess the effects of velocity, route difficulty, and anatomical variation on the energetic cost of climbing within humans. Twelve experienced rock climbers climbed on an indoor wall over a range of difficulty levels and velocities, with energy expenditure measured via respirometry. We found no effect of body mass or limb proportions on mass-specific cost of transport among subjects. Mass-specific cost of transport was negatively correlated with climbing velocity. Increased route difficulty was associated with slower climbing velocities and thus higher costs, but there was no statistically significant effect of route difficulty on energy expenditure independent of velocity. Finally, human climbing costs measured in this study were similar to published values for other primates, suggesting arboreal adaptations have a negligible effect on climbing efficiency.

PMID:34160049 | DOI:10.1242/jeb.234567

Eur J Prev Cardiol. 2021 Jun 23:zwab093. doi: 10.1093/eurjpc/zwab093. Online ahead of print.

ABSTRACT

AIMS: Reliably quantifying event rates in secondary prevention could aid clinical decision-making, including quantifying potential risk reductions of novel, and sometimes expensive, add-on therapies. We aimed to assess whether the SMART risk prediction model performs well in a real-world setting.

METHODS AND RESULTS: We conducted a historical open cohort study using UK primary care data from the Clinical Practice Research Datalink (2000-2017) diagnosed with coronary, cerebrovascular, peripheral, and/or aortic atherosclerotic cardiovascular disease (ASCVD). Analyses were undertaken separately for cohorts with established (≥6 months) vs. newly diagnosed ASCVD. The outcome was first post-cohort entry occurrence of myocardial infarction, stroke, or cardiovascular death. Among the cohort with established ASCVD [n = 244 578, 62.1% male, median age 67.3 years, interquartile range (IQR) 59.2-74.0], the calibration and discrimination achieved by the SMART model was not dissimilar to performance at internal validation [Harrell’s c-statistic = 0.639, 95% confidence interval (CI) 0.636-0.642, compared with 0.675, 0.642-0.708]. Decision curve analysis indicated that the model outperformed treat all and treat none strategies in the clinically relevant 20-60% predicted risk range. Consistent findings were observed in sensitivity analyses, including complete case analysis (n = 182 482; c = 0.624, 95% CI 0.620-0.627). Among the cohort with newly diagnosed ASCVD (n = 136 445; 61.0% male; median age 66.0 years, IQR 57.7-73.2), model performance was weaker with more exaggerated risk under-prediction and a c-statistic of 0.559, 95% CI 0.556-0.562.

CONCLUSIONS: The performance of the SMART model in this validation cohort demonstrates its potential utility in routine healthcare settings in guiding both population and individual-level decision-making for secondary prevention patients.

PMID:34160035 | DOI:10.1093/eurjpc/zwab093

Anal Methods. 2021 Jun 23. doi: 10.1039/d1ay00554e. Online ahead of print.

ABSTRACT

The aim of this study was to evaluate the feasibility of applying intracellularly-grown-Au-nanoparticle (IGAuNP)-based surface-enhanced Raman scattering (SERS) technology to classify two types of nasopharyngeal cancer (NPC) cell lines (CNE2 and CNE1). The IGAuNP technology provides excellent delivery efficiency of Au NPs to the cytoplasm and nucleus, thus leading to an extraordinary enhancement of the Raman signals of cells. Compared with normal Raman scattering (NRS) spectra of cells, IGAuNP-based SERS spectra not only have a high signal-to-noise ratio, but also can detect more characteristic Raman peaks, which can be used to explore more differences when comparing the biochemical components of different nasopharyngeal carcinoma cell lines. Based on the linear discriminant analysis (LDA) and support vector machine (SVM) analysis of SERS spectral data, an exciting result with a diagnostic sensitivity of 100%, specificity of 100%, and accuracy of 100%, could be achieved to differentiate CNE2 and CNE1 cells, which is better than the result obtained by NRS spectroscopy. This exploratory study indicated that the SERS technology based on IGAuNPs in conjunction with multivariate statistical analysis methods has great potential in the identification of nasopharyngeal carcinoma cell lines.

PMID:34159968 | DOI:10.1039/d1ay00554e