Tag: nevin manimala

Hernia. 2024 Nov 23;29(1):28. doi: 10.1007/s10029-024-03217-3.

ABSTRACT

PURPOSE: The aim of this study was to evaluate quality of life from the preoperative time to six months after surgery of patients who underwent a Shouldice Repair for primary inguinal hernia.

METHODS: After ethical approval, consent was obtained, and data collected from surveys and chart review. The study population was composed of male and female patients aged 16-90 years of age, who had a Shouldice Repair of a primary unilateral inguinal hernia. The EQ-5D-3L, a questionnaire applied to hernia surgery in Canada, was used to determine quality of life at the preoperative and 1 week, 1- and 6-month postoperative time. Data analysis included descriptive statistics, as well as inferential analysis.

RESULTS: From January 2023 to February 2024, 532 participants met the criteria, completed and returned the preoperative survey, and underwent primary inguinal hernia repair. The participants were mostly male (94%) with an average age of 62.18 years and BMI of 24.93 kg/m². The EQ-5D-3L health index scores and EQ-VAS health status at preoperative were 0.83 ± 0.13 and 79.5 ± 12.59. At the 1-month postoperative time, health index scores and health status had significantly increased from preoperative (score:0.91 ± 0.12, p = .001; status 83.56 ± 12.93, p = .001), and continued to significantly increase from baseline at the 6-month postoperative time (score:0.95 ± 0.10, p = .001; status:85.25 ± 12.17, p < .001).

CONCLUSION: Quality of life, as measured by the ED-5D-3L health index score, significantly improved for patients that underwent a Shouldice Repair for an inguinal hernia.

PMID:39580600 | DOI:10.1007/s10029-024-03217-3

Sci Rep. 2024 Nov 23;14(1):29069. doi: 10.1038/s41598-024-80890-5.

ABSTRACT

Percutaneous kyphoplasty (PKP) is an effective, minimally invasive treatment for Kummell’s disease, but challenges like cement leakage, fracture, and displacement remain. This study explores the use of PKP with a mesh-hold bone filling container for this disease.A retrospective analysis was conducted on nine Kummell’s disease cases treated with this technique at a spinal surgery department from June 2016 to May 2022. Pre- and postoperative evaluations included X-rays, CT scans, and 3D reconstructions. Parameters like vertebral heights, kyphotic angle, operation time, blood loss, and bone cement issues were measured. Efficacy was assessed using ODI and VAS scores.Statistical analysis showed no significant difference in posterior vertebral height before and after treatment. All other indexes improved significantly postoperatively and at follow-up. No cement leakage or displacement occurred.PKP with a mesh-hold bone filling container is a promising treatment for Kummell’s disease. It enhances reduction quality, ensures adequate bone cement filling, and reduces issues related to cement leakage, fracture, and displacement.

PMID:39580562 | DOI:10.1038/s41598-024-80890-5

Eur J Hum Genet. 2024 Nov 23. doi: 10.1038/s41431-024-01747-z. Online ahead of print.

ABSTRACT

Polygenic Risk Scores (PRS) are statistical methods estimating part of an individual’s genetic susceptibility to various disease phenotypes. Their potential clinical applications to enhance the prediction, prevention, and risk management of complex conditions motivate current research efforts worldwide. While a growing body of literature has highlighted the scientific and ethical limitations of PRS, the technology’s clinical translation will present both opportunities and challenges for the stakeholders involved. Here, a mixed-method systematic review of empirical studies was performed to gather evidence on the perspectives, attitudes, and experiences of healthcare providers, patients, and the public regarding the use of PRS in healthcare settings. The PRISMA reporting protocol was followed and 24 articles were included. Three major themes were identified. First, we reported on participants’ familiarity with the test, including their knowledge, understanding, and education on PRS’ clinical use. The second theme collects stakeholders’ motivations for taking the test and their perspectives on sensitive issues related to the return of results. Participants’ normative stances regarding the appropriate use of PRS, their benefits, and harms were presented in the third theme. The findings underscore significant knowledge gaps and challenges in the clinical interpretation of PRS among healthcare providers. On the other hand, the provision of genetic counseling benefitted patients’ understanding of PRS results and in most cases, no psychosocial burden was reported. Finally, the review highlights that stakeholders’ perspectives on the clinical use of PRS are highly context-dependent, shaped by population characteristics, disease type, and social factors, emphasizing the need for tailored approaches across diverse healthcare settings.

PMID:39580561 | DOI:10.1038/s41431-024-01747-z

Sci Rep. 2024 Nov 23;14(1):29092. doi: 10.1038/s41598-024-80934-w.

ABSTRACT

To compare the safety and effectiveness of the combination of intelligent intrarenal pressure control platforms and flexible end ureteral access sheath combined with flexible ureteroscopic lithotripsy (FURL) for the treatment of renal stones less than 2 cm with day case mode. From November 2023 to July 2024, a prospective, randomized, double-blind, parallel-controlled study was conducted to recruit 60 patients with upper urinary tract calculi measuring ≤ 2 cm in longest diameter. A total of 60 eligible patients were consecutively enrolled. Based on a pre-generated random number table and allocation scheme using SPSS 27.0, patients were assigned to either the intelligent pressure control group (IFURL, n = 30) or the head bending group (BFURL, n = 30). Blinding measures were implemented for patients, data collectors, statisticians, and analysts, with the allocation results disclosed to the surgeons prior to the start of the procedure in the operating room. The operation duration for IFURL and BFURL was 52.50 (48.00, 60.00) vs. 46.00 (36.00, 56.25), respectively (p = 0.047). Stone free rate (SFR) on the first postoperative day was 73.33% vs. 93.33% for IFURL and BFURL, respectively (p = 0.038). While, SFR was no significant difference between the two groups after two months(90.00% vs. 96.67%, p = 0.301). One patient in IFURL was readmitted after discharge due to fever 2 days post-discharge, and improved after 2 days of anti-infection treatment. One patient in BFURL was readmitted due to lumbar and abdominal pain from urine extravasation, which improved after 3 days of anti-infection treatment. SFR of one-month post-surgery for renal calculi ≤ 2 cm treated with intelligent pressure control and flexible UAS combined with FURL in day surgery mode was similar, with low infection-related complications and rehospitalization rates, showing no statistical difference. However, the overall hospitalization costs for the BFURL was lower than IFURL.

PMID:39580558 | DOI:10.1038/s41598-024-80934-w

Eur Arch Otorhinolaryngol. 2024 Nov 23. doi: 10.1007/s00405-024-09061-6. Online ahead of print.

ABSTRACT

PURPOSE: The effect of the inter-implant interval time on language and communication skills has been a subject of research for years in children with bilateral cochlear implants. This study aimed to investigate language and some attention and memory skills in children with bilateral sequential and simultaneous cochlear implants.

METHOD: The study included a total of 40 children aged between 6 and 8 years old, grouping bilateral simultaneous cochlear implanted children, sequential implanted children with 0-2 years interval, sequential implanted children with 2-4 years interval, and normal hearing peers. The language skills of the children were assessed using the Test of Language Development: Primary 4th edition, their selective attention and coping skills with disruptive effect were evaluated using the Stroop test, sustained attention and visual-motor synchronization skills were assessed using the Cancellation Test, and short-term memory skills were evaluated using the Visual Auditory Digit Span Test. The findings were analyzed using nonparametric statistical methods, with a significance level set at 0.05.

RESULTS: Children with bilateral simultaneous cochlear implants demonstrated better performance in language skills and the attention-related subtests of the Stroop test (p < 0.05). On the other hand, children with simultaneous and sequential cochlear implants achieved similar scores in the Cancellation and the Visual Auditory Digit Span Test (p > 0.05).

CONCLUSIONS: Bilateral simultaneous cochlear implantation in children is beneficial for language, selective attention, and coping with the Stroop effect. However, these children may still lag behind their normal-hearing peers in terms of language, attention, and memory skills.

PMID:39580553 | DOI:10.1007/s00405-024-09061-6

Sci Rep. 2024 Nov 23;14(1):29045. doi: 10.1038/s41598-024-80428-9.

ABSTRACT

As one of the major geological disasters in southeastern China, typhoon-induced vegetation slope instability causes significant loss of life and property each year. Despite the criticality of this issue, the response mechanism of vegetated slopes to wind loading in terms of soil deformation and stability still remains unclear. This research conducted field investigations on 330 historical landslides in Yongjia County, Zhejiang Province, analyzing their spatiotemporal distribution and developmental characteristics to establish a conceptual model. The influence of wind and vegetation conditions on slope dynamic parameters and soil strength parameters were subsequently determined through numerical simulations using FLAC3D software, model tests, and direct shear tests. The results show that: (1) The influence of wind on the dynamic response of vegetated slopes is significantly affected by wind speed. At wind forces ≤ 12 (hurricane: 32.7-36.9 m/s), vegetation plays a positive role in enhancing slope stability. At wind forces ≥ 13 (typhoon: 37.0-41.4 m/s), vegetation exerts a negative influence under the combined action of strong wind loads. (2) Based on the experimentally determined evolution of soil strength parameters, a formula c (v, w) was fitted to express the variation of cohesion with wind speed (v) and moisture content (w). (3) The optimized evaluation model demonstrates increased sensitivity compared to the traditional model, resulting in a 17.88% increase in sliding force and a 10.62-11.64% increase in anti-sliding force. This research accounts for both the direct and indirect effects of wind loading on vegetated slopes. The findings are expected to enhance the stability assessment of vegetated slopes under strong winds and facilitate the development of more accurate machine learning and statistical models in the future.

PMID:39580534 | DOI:10.1038/s41598-024-80428-9

Parasit Vectors. 2024 Nov 23;17(1):484. doi: 10.1186/s13071-024-06577-y.

ABSTRACT

BACKGROUND: The WHO Global Malaria Programme advocates for a comprehensive, strategic approach to managing insecticide resistance, highlighting the importance of using multiple insecticides with different modes of action through rotations and combinations. To slow the spread of resistance, it is essential to develop and evaluate new formulations that feature unique modes of action and extended residual effects. Addressing this need, Mitsui Chemicals Crop & Life Solutions, Inc., developed VECTRON™ T500, a new indoor residual spraying (IRS) formulation using broflanilide, applied at a dosage of 100 mg AI/m². This formulation was tested in a Phase III community trial, alongside Actellic^® 300CS, a commonly used IRS product containing pirimiphos-methyl, applied at the recommended dosage of 1000 mg AI/m².

METHODS: Monthly WHO wall cone bioassays were performed to assess the efficacy of the interventions using three mosquito strains: the laboratory-bred, insecticide-susceptible Anopheles gambiae s.s. Kisumu strain, the insecticide-resistant Anopheles coluzzii VKPer strain, and wild Anopheles gambiae s.l. mosquitoes from the Vallée du Kou, where the study was conducted. Vector surveillance was carried out to compare the results between sites treated with VECTRON™ T500, Actellic^® 300CS, and an untreated control site. In addition, any reported adverse effects were closely monitored to evaluate the community’s acceptance of VECTRON^™ T500.

RESULTS: VECTRON™ T500 consistently achieved 100% mortality across all wall types for both susceptible and resistant mosquito strains over the 12-month period. In comparison, Actellic^® 300CS induced < 80% mortality for both strains, irrespective of the wall substrate. When assessing delayed mortality in An. gambiae s.l. mosquitoes collected from sites treated with Actellic^® 300CS (VK1) and VECTRON™ T500 (VK3), a statistically significant difference was noted after a 72-h holding period compared to the control site (RR = 0.51, CI95% = [0.31-0.6], P = 0.0026). Additionally, no adverse events were reported in households sprayed with VECTRON™ T500.

CONCLUSIONS: The residual efficacy of VECTRON^™ T500 extended for 12 months post-spraying, effectively covering the full malaria transmission season while maintaining high mortality rates in pyrethroid-resistant malaria vectors. VECTRON^™ T500 demonstrated non-inferiority in performance compared to Actellic^® 300CS, the standard reference product. This new IRS formulation has the potential to play a crucial role in managing insecticide resistance by being integrated into a rotational strategy alongside other IRS products containing insecticides with different modes of action.

PMID:39580476 | DOI:10.1186/s13071-024-06577-y

Sci Rep. 2024 Nov 23;14(1):29060. doi: 10.1038/s41598-024-76541-4.

ABSTRACT

Landslide susceptibility map (LSM) plays an important role in providing the knowledge of slopes prone to future landslides. However, the applicability of LSM is often hindered due to high cost of data collection especially in mountainous region such as Himalayas. Therefore, this study proposes transfer learning approach (TL) to improve the performance of LSM by transferring the information from the data rich region (source) to data scare region (target). Two machine learning based model are trained in source area which is then transferred for prediction in target area and a source trained model combined with the knowledge of target is used for the prediction in the target area. The applicability of the proposed approach is tested considering Mandi district as source area and Kullu and Rudraprayag districts as target areas. Independent variables which included 11 landslide conducive factors from the source and target area, the independence was critically analysed using multi-collinearity test, while the geomorphic similarity was assessed using KL divergence method. Efficient machine learning method such as random forest (RF) and multi-layer perceptron (MLP) was used to train the models in both areas, statistical measure such as AUC-ROC, precision, recall, F-score, and accuracy were used to evaluate the performance of the LSMs. The results demonstrated the proposed approach for target area 1, the AUC value increased from 0.908 (Target trained on itself), to 0.942 (Target-Transfer Learned (TL)) and 0.959 (Target Combined) for RF and 0.896, 0.907 and 0.946 for MLP. Additionally, an increase in the precision was observed in RF while all other statistical measures increased to 0.023 for precision, 0.022 for recall, 0.023 for F-score and 0.066 for accuracy in the case of MLP. While on the other hand, in the case of target area 2, the AUC value for RF, ranged from 0.95 (Target area trained on itself), 0.80 (target TL) and 0.98 (target combined) and for MLP the AUC ranged from 0.82 for the source trained model while 0.84 for LSM obtained when both target and source data was used. Thus, the results revealed that proposed TL approach can be effective in improving the performance of LSM in data scare region in Himalayan region, thereby providing a promising approach in overcoming the issue of data limitation.

PMID:39580472 | DOI:10.1038/s41598-024-76541-4

Alzheimers Res Ther. 2024 Nov 23;16(1):254. doi: 10.1186/s13195-024-01620-7.

ABSTRACT

BACKGROUND: The spread of tau pathology closely correlates with the disease course and cognitive decline in Alzheimer’s disease (AD). Tau-targeting immunotherapies are being developed to stop the spread of tau pathology and thus halt disease progression. In this post hoc analysis of the ADAMANT clinical trial, we examined the performance of AADvac1, an active immunotherapy targeting the microtubule-binding region (MTBR) of tau, in a subgroup of participants with elevated plasma p-tau217, indicating AD-related neuropathological changes.

METHODS: ADAMANT was a 24-month, randomized, placebo-controlled, parallel-group, double-blinded, multicenter, phase 2 clinical trial in subjects with mild AD. The trial participants were randomized 3:2 to receive six doses of AADvac1 or placebo at 4-week intervals, followed by five booster doses at 14-week intervals. The primary outcome was safety. The secondary outcomes were the Clinical Dementia Rating-Sum of Boxes (CDR-SB), the Alzheimer’s Disease Cooperative Study – Activities of Daily Living score for Mild Cognitive Impairment 18-item version (ADCS-ADL-MCI-18), and immunogenicity. Volumetric MRI, plasma neurofilament light (NfL), and glial fibrillary acidic protein (GFAP) were exploratory outcomes. The inclusion criterion for this post-hoc analysis was a baseline plasma p-tau217 level above the cutoff for AD.

RESULTS: Among 196 ADAMANT participants, 137 were positive for plasma p-tau217 (mean age 71.4 years, 59% women). AADvac1 was safe and well tolerated in this subgroup. AADvac1 reduced the rate of accumulation of log-plasma NfL by 56% and that of GFAP by 73%. The treatment differences in the CDR-SB and ADCS-ADL-MCI-18 scores favored AADvac1 but were not statistically significant. AADvac1 had no effect on whole-brain volume but nonsignificantly reduced the loss of brain cortical tissue in several regions. Importantly, the impact on the study outcomes was more pronounced in participants with higher anti-tau antibody levels.

CONCLUSIONS: These results suggest that AADvac1 tau immunotherapy can reduce plasma biomarkers of neurodegeneration and neuroinflammation. These findings and possible observations on brain atrophy and cognition are hypothesis-generating and warrant further evaluation in a larger clinical trial.

TRIAL REGISTRATION: EudraCT 2015-000630-30 (primary) and NCT02579252.

PMID:39580468 | DOI:10.1186/s13195-024-01620-7

J Ovarian Res. 2024 Nov 23;17(1):234. doi: 10.1186/s13048-024-01533-x.

ABSTRACT

OBJECTIVE: To analyze how the PD-L1 expression and CD8 + tumor infiltrating lymphocyte (TIL) levels in biopsy samples before neoadjuvant chemotherapy (NACT) can predict chemotherapy response score and survival for advanced high-grade serous ovarian cancer (HGSC).

METHODS: We retrospectively analyzed 45 patients with advanced epithelial ovarian cancer between 2010 and 2018, who had received at least three cycles of NACT. PD-L1 expression and CD8 + TIL levels were evaluated by immunohistochemical staining in the pre-NAC tumor samples from which the patients had been diagnosed. The post-NACT tissue samples taken during interval debulking surgery (IDS) were used to evaluate the chemotherapy response score (CRS).

RESULTS: Among all the patients, CRS 1 (no response) was found in 8 patients, CRS 2 (partial response) in 28 patients, and CRS 3 (complete response) in 9 patients. A total of 20 (44.4%) patients had high intratumoral CD8 + TILs (iCD8 + TILs) levels, and 35 (77.8%) patients had high expression stromal CD8 + TILs (sCD8 + TILs). No statistically significant relationship was found between high and low expression of i/s CD8 + TILs levels with PFS and CRS. The study found that 33 (73.3%) patients had high levels of stromal PD-L1 (sPD-L1) expression and 28 (62.2%) patients had high levels of intratumoral PD-L1 (iPD-L1) expression. In the iPD-L1 group, patients with low expression had a PFS of 28 months, whereas those with high expression had a PFS of 17 months (p = 0.028). Among the patients with high iPD-L1 expression, 23 (82.1%) patients showed CRS2, 4 (14.3%) showed CRS3, and only 1 (3.6%) showed CRS1 (p < 0.001). However, high or low expression sPD-L1 did not significantly affect PFS and CRS (p = 0.928 and p = 0.305; respectively).

CONCLUSIONS: We found that iPD-L1 expression levels in diagnostic biopsy in ovarian cancer can predict the chemotherapy response score in interval debulking surgery.

PMID:39580458 | DOI:10.1186/s13048-024-01533-x