Tag: nevin manimala

Front Clin Diabetes Healthc. 2024 Nov 14;5:1432551. doi: 10.3389/fcdhc.2024.1432551. eCollection 2024.

ABSTRACT

INTRODUCTION: Diabetic retinopathy (DR) is a highly prevalent microvascular disease among diabetic patients, resulting in irreversible blindness. However, there is a dearth of evidence on diabetic retinopathy (DR) and its associated factors in eastern Ethiopia. The study aimed to determine the prevalence of diabetic retinopathy (DR) and its associated factors among type 1 and type 2 diabetic patients at public hospitals in eastern Ethiopia.

METHOD: A hospital-based comparative cross-sectional was conducted among 520 diabetic patients. Epidata software was used for data entry, and STATA version 17 was used for statistical analysis. Multivariate binary logistic regression was computed to identify factors associated with DR. The Hosmer and Lemeshow chi-square test assessed goodness of fit.

RESULTS: The overall prevalence of DR was 43.5%. The prevalence of diabetic retinopathy among type 1 DM was 38.5%, and the prevalence of DR among type 2 DM was 48.5%. Age >60 [AOR = 4.64 95% CI (1.60, 13.51)], being male [AOR = 4.05 95% CI (1.51, 10.97)], and having complications [AOR = 0.01 95% CI (0.003, 0.04)] were significantly associated with DR among type 1 diabetes. Having a family history of DM [AOR = 1.57 95% CI (1.76, 3.24)], poor glycemic status [AOR = 1.91 95% CI (1.56, 2.83)], and having complications [AOR = 11.07 95% CI (4.89, 25.13)] were significantly associated with DR among type 2 diabetes.

CONCLUSIONS: In the current study, the prevalence of DR was 43.5%. The prevalence was higher among type 2 diabetes compared to type 1 diabetes. Factors such as poor glycemic control, older age, male sex, a family history of diabetes, and complications related to diabetes were significantly associated with DR. To minimize the impact of diabetics, it requires regular screening programs for diabetic patients, especially those with poor glycemic control and other identified risk factors.

PMID:39611059 | PMC:PMC11602483 | DOI:10.3389/fcdhc.2024.1432551

Health Sci Rep. 2024 Nov 26;7(12):e70207. doi: 10.1002/hsr2.70207. eCollection 2024 Dec.

ABSTRACT

BACKGROUND AND AIMS: Due to the increasing use of imaging services, this study aimed to estimate the number of unnecessary imaging services, normal and abnormal imaging examinations, and their determinant factors.

METHODS: This cross-sectional study was conducted at a district hospital in East Azerbaijan, Iran. Retrospective data were collected from the electronic medical records of patients referred to the Imaging Department between March and August 2022, using the Hospital Information System (HIS). Descriptive statistics and χ ² tests were performed, followed by hierarchical logistic regression with AOR, 95% CI, using SPSS-24 for analysis.

RESULTS: About 28% of imaging examinations with abnormal results and 21% of the examinations with normal results were unnecessary. The probability of ultrasound abnormal imaging results was 67% lower than computed tomography (CT) scan (CT-scan) (adjusted odds ratio (AOR) = 0.33 (0.212-0.50); p < 0.001). One year increase of patient age is associated with a 1% lower likelihood of having normal imaging (AOR = 0.99 (0.98-0.99); p < 0/001). Women were 20% less likely than men to have abnormal imaging results (AOR = 0.80 (0.65-0.98); p = 0.035). The probability of necessary imaging decreases by 1% for 1 year increase in patient age (p = 0.017), on the other hand, the probability of unnecessary chest radiography was 5% higher than a brain CT-scan imaging (AOR = 2.05 (1.19-3.51); p = 0.009).

CONCLUSIONS: Unnecessary imaging were more frequently performed on the older patients. Additionally, ultrasound was less likely than CT-scans to show abnormal findings, while chest radiography was more frequently deemed unnecessary compared to brain CT-scans. These insights highlight the need for age- and modality-specific guidelines to reduce unnecessary imaging and improve diagnostic efficiency.

PMID:39611021 | PMC:PMC11599613 | DOI:10.1002/hsr2.70207

PeerJ. 2024 Nov 25;12:e18542. doi: 10.7717/peerj.18542. eCollection 2024.

ABSTRACT

BACKGROUND: This study provides new information on long non-coding RNA (lncRNA) and messenger RNA (mRNA) expression profiles in the hair follicles of Hetian sheep via the sequencing and analysis of the transcriptome of skin hair follicles during three periods of periodicity change. This is important for improving the quality of carpet wool, providing a preliminary basis for further research on the targeting relationship of these mRNAs and their target genes, and providing a scientific basis for marker-assisted selection of Hetian sheep.

METHODS: The periodic variation of anagen (P I, May, n = 3), catagen (p II, October, n = 3), and telogen (p III, January, n = 3) of the skin hair follicle tissue of three Hetian sheep ewes were selected. Skin samples were collected from the right mid-side of each sampled sheep at three hair follicle developmental stages. The three sheep were used for each developmental stage as biological and technical replicates for transcriptome sequencing and analysis.

RESULTS: The statistical power of this experimental design, calculated in RNASeqPower, was 0.92. Differential expression analysis revealed 81 lncRNAs that were differentially expressed (46 up-regulated and 35 down-regulated) and 129 mRNAs that were differentially expressed (46 up-regulated and 83 down-regulated) during the PI and PII periods. Between the PI and PIII periods, a total of 144 differentially expressed lncRNAs and 693 differentially expressed mRNAs were identified. Of these, 73 lncRNAs were significantly up-regulated and 71 were significantly down-regulated, while 474 mRNAs were significantly up-regulated and 219 were down-regulated. Additionally, a total of 87 lncRNAs were found to be differentially expressed, with 40 up-regulated and 47 down-regulated, along with 39 differentially expressed mRNAs (23 up-regulated and 16 down-regulated), between the PII and PIII stages. The functional assessment revealed that the mRNA expressed in the cells is related to the membrane, cell processes, metabolism, extracellular region, and other GO items. It is enriched in thyroid hormone synthesis, choline metabolism, cancer, AMPK, Hedgehog, and other signaling pathways.

CONCLUSION: A total of 2,286 lncRNAs (including 965 known and 1,321 novel lncRNAs) and 20,879 mRNAs were identified. These co-expressed differentially expressed genes could be used as candidate genes for studying the periodic changes of the hair follicles in Hetian sheep.

PMID:39611017 | PMC:PMC11604043 | DOI:10.7717/peerj.18542

Int J Nanomedicine. 2024 Nov 23;19:12461-12481. doi: 10.2147/IJN.S479937. eCollection 2024.

ABSTRACT

INTRODUCTION: Given the increasing frequency of drug-resistant bacteria and the limited progress in developing new antibiotics, it is necessary to explore new methods of combating microbial infections. Nanoparticles, particularly silver nanoparticles (Ag-NPs), have shown exceptional antibacterial characteristics; however, elevated concentrations of Ag-NPs can produce noticeable levels of toxicity in mammalian cells.

AIM: This study examined the potential synergistic effect of combining a low dosage of Ag-NPs and anti-pseudomonas drugs against Pseudomonas aeruginosa (ATCC strain) and eleven clinical isolates from cystic fibrosis patients.

METHODS: The Ag-NPs were chemically produced by utilizing a seed extract from Peganum Harmala and characterized via ultraviolet-visible spectroscopy and scanning electron microscopy. The broth microdilution technique was utilized to investigate the minimum inhibitory concentration (MIC) of Ag-NPs and eight antibiotics (Piperacillin, Ciprofloxacin, Levofloxacin, Meropenem, Amikacin, Ceftazidime, Gentamicin, Aztreonam). The fractional inhibitory concentration index (FICI) was determined via the checkerboard method to evaluate the synergistic effects of Ag-NPs and various antibiotics.

RESULTS: The biosynthesized Ag-NPs were uniformly spherical and measured around 15 nm in size. When combined with antibiotics, Ag-NP produced statistically significant reductions in the amount of antibiotics required to completely prevent P. aeruginosa growth for all strains. The findings revealed that the MIC of Ag-NPs was 15 ug/mL for all strains which decreased substantially when administered with antibiotics at a dose of 1.875-7.5 ug/mL. The majority of Ag-NP and antibiotic combinations exhibited a synergistic or partially synergistic impact. This was particularly noticeable in combinations containing Meropenem, Ciprofloxacin, and Aztreonam (in which the FIC index was less than or equal to 0.5).

CONCLUSION: The findings revealed that combining Ag-NPs with antibiotics was more effective than using Ag-NPs or antibiotics in isolation and that combinations of Ag-NPs and antimicrobial agents displayed synergistic activity against the majority of strains assessed.

PMID:39611007 | PMC:PMC11602434 | DOI:10.2147/IJN.S479937

Contemp Clin Trials Commun. 2024 Nov 4;42:101388. doi: 10.1016/j.conctc.2024.101388. eCollection 2024 Dec.

ABSTRACT

This paper proposes a platform trial for conducting A/B tests with multiple arms and interim monitoring to investigate the impact of several factors on the expected sample size and probability of early stopping. We examined the performance of three stopping boundaries: O’Brien Fleming (OBF) stopping for either futility or difference (both), Pocock stopping for futility only, and fixed sample size design. We simulated twelve scenarios of different orders of arms based on various effect sizes, as well as considered 1 or 3 interim looks. The overall findings are summarizing in a flowchart to provide intuitive guidance for the design of the platform based on the simulation. We found that it is better to use OBF stopping for both if there is any effective variant and the trial is sufficiently powered to detect the expected effect size. If the study is underpowered to detect a difference, we recommend fixed sample size design to gather as much information as possible, however if the expected sample size is important to minimize, we recommend using Pocock boundaries with futility monitoring. Our results aimed at helping high-tech companies conduct their own studies without requiring extensive knowledge of clinical trial design and statistical methodology.

PMID:39611005 | PMC:PMC11602995 | DOI:10.1016/j.conctc.2024.101388

J Med Internet Res. 2024 Nov 11. doi: 10.2196/59921. Online ahead of print.

ABSTRACT

BACKGROUND: An increasing aging population, accompanied by a shortage of residential aged care homes and workforce, and consumer feedback, has driven a growing interest in enabling older people to age in place through home-based care. In this context, smart home technologies for remote health monitoring have gained popularity in supporting older people to live in their own homes.

OBJECTIVE: This study aims to investigate the impact of smart home monitoring on multiple outcomes, including quality of life, activities of daily living, and depressive symptoms among older people living in their own homes over a 12-month period.

METHODS: We conducted an open-label parallel-group randomized controlled trial. The control group continued to receive their existing care from aged care service providers. Meanwhile the intervention group, in addition to receiving their usual aged care services, had their activities of daily living monitored using a smart home platform. Surveys including Adult Social Care Outcomes Toolkit (ASCOT), EuroQol-5 Dimensions-5 Levels (EQ-5D-5L), Katz Index of Independence in Activities of Daily Living (Katz ADL), Lawton Instrumental Activities of Daily Living Scale (IADL), and Geriatric Depression Scale (GDS) were conducted at baseline, 6 and 12 months from baseline. Linear mixed-effects models were used to compare the difference between the intervention and control groups, with the ASCOT as the primary outcome measure.

RESULTS: The data from 130 participants were used in the analysis, with no significant differences in baseline characteristics between the control group (n = 61) and the intervention group (n = 69). In comparison to the control group, the intervention group had a higher ASCOT score at the 6-month assessment (mean difference: 0.045; 95% CI: 0.001 to 0.089; Cohen d: 0.377). However, this difference did not persist at the 12-month assessment (mean difference: 0.031; 95% CI: -0.014 to 0.076; Cohen d: 0.259). There were no significant differences in EQ-5D-5L, Katz ADL, IADL, and GDS observed between the intervention and control groups at the 6-month and 12-month assessments.

CONCLUSIONS: The study demonstrates that smart home monitoring can improve social care-related quality of life for older people living in their own homes. However, the improvement was not sustained over the long term. The lack of statistically significant findings and diminished long-term improvements may be attributed to the influence of the COVID-19 pandemic during the later stage of the trial. Further research with a larger sample size is needed to evaluate the effect of smart home monitoring on broader quality of life measures.

CLINICALTRIAL: Australian New Zealand Clinical Trials Registry ACTRN12618000829213; https://tinyurl.com/2n6a75em.

INTERNATIONAL REGISTERED REPORT: RR2-10.2196/31970.

PMID:39608020 | DOI:10.2196/59921

Hum Factors. 2024 Nov 28:187208241302475. doi: 10.1177/00187208241302475. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aims to compare the relative sensitivity between scene-independent and scene-dependent eye metrics in assessing trainees’ performance in simulated psychomotor tasks.

BACKGROUND: Eye metrics have been extensively studied for skill assessment and training in psychomotor tasks, including aviation, driving, and surgery. These metrics can be categorized as scene-independent or scene-dependent, based on whether predefined areas of interest are considered. There is a paucity of direct comparisons between these metric types, particularly in their ability to assess performance during early training.

METHOD: Thirteen medical students practiced the peg transfer task in the Fundamentals of Laparoscopic Surgery. Scene-independent and scene-dependent eye metrics, completion time, and tool motion metrics were derived from eye-tracking data and task videos. K-means clustering of nine eye metrics identified three groups of practice trials with similar gaze behaviors, corresponding to three performance levels verified by completion time and tool motion metrics. A random forest model using eye metrics estimated classification accuracy and determined the feature importance of the eye metrics.

RESULTS: Scene-dependent eye metrics demonstrated a clearer linear trend with performance levels than scene-independent metrics. The random forest model achieved 88.59% accuracy, identifying the top four predictors of performance as scene-dependent metrics, whereas the two least effective predictors were scene-independent metrics.

CONCLUSION: Scene-dependent eye metrics are overall more sensitive than scene-independent ones for assessing trainee performance in simulated psychomotor tasks.

APPLICATION: The study’s findings are significant for advancing eye metrics in psychomotor skill assessment and training, enhancing operator competency, and promoting safe operations.

PMID:39608016 | DOI:10.1177/00187208241302475

Radiol Oncol. 2024 Nov 28;58(4):535-543. doi: 10.2478/raon-2024-0059. eCollection 2024 Dec 1.

ABSTRACT

BACKGROUND: In patients with right-sided breast cancer the liver can be partially irradiated during adjuvant radiotherapy (RT). We aimed to determine breast cancer RT effects on liver using with magnetic resonance elastography (MRE) and biological results.

PATIENTS AND METHODS: This retrospective study enrolled 34 patients diagnosed with right-sided breast cancer who underwent adjuvant RT. Liver segment assessments were conducted using MRE for all participants. Additionally, a complete blood count and liver enzyme analysis were performed for each patient. All measurements were taken both prior to the initiation and upon completion of RT.

RESULTS: A statistically significant difference was found in ALT (p = 0.015), ALP (p = 0.026), total protein (p = 0.037), and albumin (p = 0.004) levels before and after RT. The highest mean liver stiffness (kPa) value was recorded in segment 8, while the lowest was observed in segment 6. A weak but statistically significant positive correlation was found between segment 5 stiffness and liver volume (p = 0.039). Additionally, a statistically significant positive correlation was detected between ALP levels and the stiffness values in segment 4A (p = 0.020) and segment 6 (p = 0.003). Conversely, a weak negative correlation was observed between the stiffness values in segment 8 and post-RT total protein levels (p = 0.031).

CONCLUSIONS: MRE can help us identify the level of fibrotic stiffness in the liver segments within the RT area without establishing clinical symptoms. MRE can support the clinician in evaluating the liver functions of right breast cancer patients who underwent RT. We assume these results will facilitate new studies with a large number of patients on MRE imaging at certain intervals in the follow-up of patients with right breast cancer who received RT before the development of radiation-induced liver disease (RILD).

PMID:39608011 | DOI:10.2478/raon-2024-0059

Radiol Oncol. 2024 Nov 28;58(4):573-579. doi: 10.2478/raon-2024-0056. eCollection 2024 Dec 1.

ABSTRACT

BACKGROUND: To compare the diagnostic accuracy and predictive value of aneurysm sac volume measurement versus maximum diameter measurement of abdominal aortic aneurysm sac after endovascular aneurysm repair (EVAR) in patients with type II endoleak.

PATIENTS AND METHODS: Retrospective study on a cohort of 103 patients who presented with a type II endoleak after EVAR for infrarenal abdominal aortic aneurysm. Maximum diameter and volumetric measurements were calculated on computed tomography follow-up scans at 3 months and 1 year after index surgery. Pearson correlation coefficient was used to determine linear association between diameter and volume; Mann-Whitney U test was used to compare patients with and without later intervention for type II endoleak with regard to diameter and volume change.

RESULTS: The correlation between diameter and volume measurement was high (Rho: 0.890-0.980 with P < 0.0001). In 38 out of 103 patients (37%) with type II endoleak, a later intervention for endoleak management was performed; early diameter (P = 0.097), or volume (P = 0.387) change could not predict risk for later intervention.

CONCLUSIONS: Both diameter and volume measurements can be used in the imaging follow-up of patients with endoleak type II after EVAR; however early changes in diameter or volume of the aneurysm sac cannot predict late intervention for type II endoleak.

PMID:39608008 | DOI:10.2478/raon-2024-0056

Radiol Oncol. 2024 Nov 28;58(4):494-500. doi: 10.2478/raon-2024-0062. eCollection 2024 Dec 1.

ABSTRACT

BACKGROUND: Whole-body positron emission tomography/magnetic resonance imaging (WB-PET/MRI) is increasingly used in the initial evaluation of oncology patients. The purpose of this study was to compare the diagnostic performance of WB MRI sequences, attenuation-corrected raw data positron-emission tomography (AC PET), and PET/MRI fused images to detect bone metastases.

PATIENTS AND METHODS: We included 765 consecutive oncologic patients who received WB-PET/MRI from between January 2017 and September 2023. The presence of bone metastases was assessed using the individual sequences by two radiologists. Interobserver agreement was calculated. A receiver operating characteristic (ROC) analysis was performed to assess the performance of each individual sequence and fused images.

RESULTS: Interobserver agreement for the detection of bone metastases on all sequences ranged from good to very good. The reading of the combination of MRI sequences with PET images showed statistically significantly better performance than the reading of individual MRI sequences and PET component only. Contrast enhanced T1 W Volume-interpolated breath-hold examination (CE T1W VIBE) sequence superior to PET for the detection of bone metastasis, but the statistical significance was not as high as with T1W-PET and CE T1W-PET fused images. The highest performance was achieved by the fused CE T1W-PET images with sensitivity of 100%, specificity of 92%, PPV of 96%, and NPV of 100%.

CONCLUSIONS: The combination of these CE T1W VIBE sequences with PET images have the highest diagnostic performance in detecting bone metastases in oncologic patients. This sequence should be integrated in WB-PET/MRI acquisitions for initial staging of cancer.

PMID:39608007 | DOI:10.2478/raon-2024-0062