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Characterization of Sleep Structure and Autonomic Dysfunction in REM Sleep Behavior Disorder

IEEE Open J Eng Med Biol. 2024 May 7;5:859-866. doi: 10.1109/OJEMB.2024.3397550. eCollection 2024.

ABSTRACT

Goal: REM Sleep Behavior Disorder (RBD) is a REM parasomnia that is associated to high risk of developing α-synucleinopathies, as Parkinson’s disease (PD) or dementia with Lewy bodies, over time. This study aims at investigating the presence of autonomic dysfunctions in RBD subjects, with and without PD, by assessing their sleep structure and autonomous nervous system activity along the different sleep stages. Methods: To this aim, an innovative framework combining a sleep transition model, by Markov chains, with an instantaneous assessment of autonomic state dynamics by statistical modeling of heart rate variability (HRV) dynamics through a point-process approach, was introduced. Results: In general, RBD groups showed lower HRV than controls across all sleep stages, as well as higher probabilities of transitioning towards lighter sleep stages. Subjects also affected by PD present an even lower HRV, but better sleep continuity. Conclusions: RBD patients suffer from sleep fragmentation and overall autonomic dysfunction, mainly due to lower autonomic activation across all sleep stages. Coexistence of PD seems to improve sleep quality, possibly due to a sleep-related relief of their symptoms.

PMID:39559778 | PMC:PMC11573400 | DOI:10.1109/OJEMB.2024.3397550

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Antimicrobial role of Lavandula angustifolia towards Candida albicans, Streptococcus mutans, Staphylococcus aureus and anti-adherence effect on denture base resin

J Oral Biol Craniofac Res. 2024 Nov-Dec;14(6):815-824. doi: 10.1016/j.jobcr.2024.10.014. Epub 2024 Nov 4.

ABSTRACT

OBJECTIVES: The objective of the study was to determine the antimicrobial efficacy of Lavandula angustifolia (True Lavender extract) towards Candida albicans, Streptococcus mutans, Staphylococcus aureus pathogens. Varying proportions of the extract was incorporated into polymethyl methacrylate (PMMA) denture base resin and the anti-adherent effect was investigated.

METHODS: An in-vitro study was performed after pure extract was obtained from Lavandula angustifolia (LA) flowers using a solvent based hot extraction process. Chromatographic analysis and computational molecular docking were done to analyze its phytoconstituents with potential target-ligand bond. Tests of antimicrobial susceptibility, minimum inhibitory concentration, minimum bactericidal and fungicidal dosages and in-vitro cytotoxicity were performed. Different proportions of LA extract (0, .5, 1.0, 1.5, and 2.0 %) were added to PMMA resin to assess anti-adherence property. Obtained data were statistically analyzed with One-way ANOVA followed by Tukey post-hoc tests.

RESULTS: The reports revealed significant antimicrobial susceptibility against the test pathogens compared to control drugs (P > 0.05). A minimum concentration of .02 mg of lavender extract inhibited microbial growth with low cytotoxicity (P < 0.05). The highest anti-adherent activity was observed in the .5 % LA-incorporated PMMA resin group (P = 0.0001).

CONCLUSIONS: Incorporating lavender extract into denture base resin demonstrated promising antimicrobial properties. This investigation encourages further research to understand its effects on mechanical and physical properties of reinforced dental resins.

PMID:39559748 | PMC:PMC11570514 | DOI:10.1016/j.jobcr.2024.10.014

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Lot quality assurance sampling for coverage evaluation of a new vaccine: A pilot study

Vaccine X. 2024 Nov 1;21:100578. doi: 10.1016/j.jvacx.2024.100578. eCollection 2024 Dec.

ABSTRACT

BACKGROUND: Worldwide, vaccine-preventable diseases have been a significant cause of mortality in the under-5 age group. To reduce the disease burden, new vaccines are being introduced in every country’s immunization programmes. For this to happen, high vaccination coverage is necessary. However, rapidly identifying the areas that fail to reach the expected coverage becomes cumbersome. During recent years, lot quality assurance sampling (LQAS) has been widely used in evaluating immunization coverage across the globe. The present study aims to pilot this approach for field monitoring of a new vaccine against routine concurrent field monitoring in one of the North-Eastern states of India.

METHODOLOGY: For LQAS, a community-based cross-sectional study was undertaken among 55 children aged 0-23 months in all 5 Primary health centres (lots) of Medziphema block, Dimapur, Nagaland. The total sample size for LQAS was calculated based on α = 5, β = 90 using Lemeshow and Taber-LQAS table with a target level of immunization defined as 90 % and the lower limit set to 55 %. For the concurrent field monitoring, a sample of 30 children in the same age group was selected through random sampling. Pre-designed, pre-tested questionnaire for the caregivers, scripted on a digital tool was employed with verification of immunization card and caregiver’s recall. Data was analyzed using SPSS software version 25.0.

RESULTS: The study found a slight difference in the percentage of children age-appropriately vaccinated for PCV (as per the schedule) in concurrent field monitoring (93.3 %) and LQAS (90.9 %). However, no statistically significant difference was found in comparing the immunization coverage using both methodologies (p > 0.05).

CONCLUSION: The study findings encourage that LQAS can be considered for monitoring the immunization coverage of a newly introduced vaccine. It offers the added advantage of identifying poor/low-performing pockets that require focused attention.

PMID:39559738 | PMC:PMC11570966 | DOI:10.1016/j.jvacx.2024.100578

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Prognostic Value of miR-10a-3p in Non-Small Cell Lung Cancer Patients

Onco Targets Ther. 2024 Nov 14;17:1017-1032. doi: 10.2147/OTT.S475644. eCollection 2024.

ABSTRACT

PURPOSE: Poor lung cancer patients’ outcomes and survival rates demand the discovery of new biomarkers for the specific, significant, and less invasive detection of non-small cell lung cancer (NSCLC) progression. The present study aimed to investigate the potential of miRNA expression as biomarkers in NSCLC utilizing a preclinical cell culture setup based on screening of miRNAs in NSCLC cells grown in 3D cell culture.

PATIENTS AND METHODS: The study was performed using lung cancer cell lines, varying in different levels of aggressiveness: NCI-H1299, A549, Calu-1, and NCI-H23, as well as noncancerous bronchial epithelial cell line HBEC3, which were grown in 3D cell culture. Total RNA from all cell lines was extracted and small RNA libraries were prepared and sequenced using the Illumina NGS platform. The expression of 8 differentially expressed miRNAs was further validated in 89 paired tissue specimens and plasma samples obtained from NSCLC patients. Statistical analysis was performed to determine whether miRNA expression and clinicopathological characteristics of NSCLC patients could be considered as independent factors significantly influencing PFS or OS.

RESULTS: Differentially expressed miRNAs, including let-7d-3p, miR-10a-3p, miR-28-3p, miR-28-5p, miR-100-3p, miR-182-5p, miR-190a-5p, and miR-340-5p, were identified through next-generation sequencing in NSCLC cell lines with varying levels of aggressiveness. Validation of patient samples, including tumor and plasma specimens, revealed that out of the 8 investigated miRNAs, only plasma miR-10a-3p showed a significant increase, which was associated with significantly extended progression-free survival (PFS) (p=0.009). Furthermore, miR-10a-3p in plasma emerged as a statistically significant prognostic variable for NSCLC patients’ PFS (HR: 0.5, 95% CI: 0.3-0.9, p=0.029).

CONCLUSION: Our findings of screening miRNA expression patterns in NSCLC cells grown in 3D cell culture indicated that the expression level of circulating miR-10a-3p has the potential as a novel non-invasive biomarker to reflect the short-term prognosis of NSCLC patients.

PMID:39559728 | PMC:PMC11572442 | DOI:10.2147/OTT.S475644

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Dairy Intake in Relation to Prediabetes and Continuous Glycemic Outcomes: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies

Curr Dev Nutr. 2024 Sep 29;8(11):104470. doi: 10.1016/j.cdnut.2024.104470. eCollection 2024 Nov.

ABSTRACT

BACKGROUND: Modest inverse associations have been found between dairy intake, particularly yogurt, and type 2 diabetes risk. Investigating associations of dairy intake with early onset of type 2 diabetes offers opportunities for effective prevention of this condition.

OBJECTIVES: This study aims to investigate the relationships between the intake of different dairy types, prediabetes risk, and continuous glycemic outcomes.

METHODS: Systematic literature searches across multiple databases were performed of studies published up to September 2023. Included were prospective cohort studies in healthy adults that examined the association between dairy intake and prediabetes risk according to diagnostic criteria, or continuous glycemic markers. A dose-response random-effects meta-analysis was used to derive incremental relative risks (RRs) for associations of total dairy, fermented dairy, milk, yogurt, cheese (all total, high-fat, and low-fat), cream, and ice cream with prediabetes risk adjusted for sociodemographic, health and cardiometabolic risk factors, and dietary characteristics.

RESULTS: The meta-analyses encompassed 6653 prediabetes cases among 95,844 individuals (age range 45.5-65.5 y) including 6 articles describing 9 cohorts. A quadratic inverse association was observed for total dairy intake and prediabetes risk, with the lowest risk at 3.4 servings/d (RR: 0.75; 95% confidence interval: 0.60, 0.93; I 2 = 18%). Similarly, total, and high-fat cheese exhibited nonlinear inverse associations with prediabetes risk, showing the lowest risk at 2.1 servings/d (0.86; 0.78, 0.94; I 2 = 0%, and 0.90; 0.81, 0.99; I 2 = 12%), but a higher risk at intakes exceeding 4 servings/d. Ice cream intake was linearly associated with prediabetes risk (0.85; 0.73, 0.99; I 2 = 0% at the highest median intake of 0.23 servings/d). Other dairy types showed no statistically significant associations. The systematic review on dairy intake and glycemic outcomes showed considerable variabilities in design and results.

CONCLUSIONS: The findings suggest an inverse association between moderate dairy and cheese intake in preventing prediabetes. The potential for reverse causation and residual confounding highlights the need for studies with comprehensive repeated measurements.

TRIAL REGISTRATION NUMBER: PROSPERO 2023 CRD42023431251.

PMID:39559723 | PMC:PMC11570412 | DOI:10.1016/j.cdnut.2024.104470

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Clinical Characteristics and Valve Lesions in Rheumatic Heart Disease Among Children at Hiwot Fana Comprehensive Specialized Hospital: A Comparative Study of Newly Diagnosed and Known Cases

Glob Pediatr Health. 2024 Nov 17;11:2333794X241298811. doi: 10.1177/2333794X241298811. eCollection 2024.

ABSTRACT

Background. Rheumatic heart disease remains a significant health burden in resource-limited settings. This study investigated the clinical characteristics and valve lesion patterns of RHD in children from Eastern Ethiopia, comparing newly diagnosed and known RHD patients. Objective. This study aimed to characterize the clinical features and valve lesion patterns in children with Rheumatic heart disease and provide a comparative analysis between newly diagnosed and known cases. Methods. A hospital-based cross-sectional study was conducted at Hiwot Fana Comprehensive Specialized Hospital from January 1 to December 31, 2021. A total of 39 children with RHD were included, with data collected from medical records, clinical assessments, and echocardiographic evaluations. Descriptive statistics and chi-square tests were used for analysis. Results. Among the 39 children studied, 25 were newly diagnosed and 14 were known RHD cases. The majority were female (71.8%). The median age was 10 years. Shortness of breath (53.9%) and cough (38.5%) were the most common presenting complaints. Only 14.3% of known RHD patients were adherent to secondary prophylaxis. Severe acute malnutrition and severe anemia were the most common comorbidities. Class IV heart failure was present in 89.7% of the patients. Echocardiographic findings revealed that all patients had mitral valve involvement, with mitral regurgitation (94.9%) being the most frequent. Conclusion. This study revealed that rheumatic diseases in children in Eastern Ethiopia present at advanced stages. Low adherence to secondary prophylaxis and high rates of severe heart failure highlights the consequences of delayed diagnosis and management. These findings underscore the urgent need for better healthcare infrastructure, enhanced prevention programs, and improved strategies to increase prophylaxis adherence to prevent disease progression and improve outcomes for affected children.

PMID:39559717 | PMC:PMC11571246 | DOI:10.1177/2333794X241298811

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Visceral Adiposity as an Independent Risk Factor for Diabetic Peripheral Neuropathy in Type 2 Diabetes Mellitus: A Retrospective Study

J Diabetes Res. 2024 Nov 11;2024:9912907. doi: 10.1155/2024/9912907. eCollection 2024.

ABSTRACT

Background: Diabetic peripheral neuropathy (DPN) impacts approximately 50% of individuals with Type 2 diabetes mellitus (T2DM), leading to severe complications such as foot ulcers and amputations. Notably, visceral adiposity is increasingly recognized as a pivotal factor in augmenting the risk of DPN. We aim to evaluate the correlation between obesity-related body composition, particularly visceral fat, and DPN to facilitate early identification of high-risk patients with T2DM. Methods: This cross-sectional analysis encompassed 113 T2DM patients from the Department of Endocrinology and Metabolism at the Second Affiliated Hospital of Fujian Medical University, conducted between September 2020 and January 2021. Patients were categorized into two cohorts: those with DPN (DPN group) and those without (NDPN group). We utilized bioelectrical impedance analysis (BIA) to determine body measurements, such as weight and visceral fat area, in addition to collecting clinical and biochemical data. Logistic regression was employed to analyze the data. Results: The study uncovered a statistically significant difference in the visceral fat area between the DPN and NDPN groups (p = 0.048). Through multivariate logistic regression analysis, the visceral fat area was identified as an independent risk factor for DPN among T2DM patients (OR 1.027; 95% CI 1.004-1.051, p = 0.022). Other significant risk factors included the duration of diabetes and the presence of diabetic retinopathy. Conclusion: The visceral fat area serves as an independent risk factor for DPN in individuals with T2DM. Implementing measures to assess and manage visceral obesity could be vital in the prevention and management of DPN. This underscores the value of technologies such as BIA in clinical and community settings for early intervention.

PMID:39559714 | PMC:PMC11573447 | DOI:10.1155/2024/9912907

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Trends of drug-resistant tuberculosis and risk factors to poor treatment-outcome: a database analysis in Littoral region-Cameroon, 2013-2022

BMC Public Health. 2024 Nov 18;24(1):3195. doi: 10.1186/s12889-024-20585-8.

ABSTRACT

INTRODUCTION: Tuberculosis(TB), currently has limited treatment options, and faces worldwide threat of drug-resistance(DR). In 2022, the DR-TB prevalence in Cameroon was 1.4% among new-cases and 8.3% among retreatment-cases. We analyzed the DR-TB database to descript the trends and DR-TB profile, treatment-outcome and associated risk-factors so-as-to propose measures to enhance program performance in Cameroon.

MATERIALS AND METHODS: We conducted a retrospective cohort study, analysed the DR-TB database of the Littoral region from 2013 to 2022. We appreciated the data-quality using zero-reporting, completeness, consistency, and validity indicators. We categorized DR-TB into Rifampicin-resistant-TB(RR-TB), multi-drug-resistant-TB(MDR-TB), pre-extensive-drug-resistant-TB(pre-XDR-TB), and XDR-TB and performed descriptive statistics. We assessed DR-TB treatment outcome targeting > 80% cure and/or completed treatment. Multiple logistic regression was used to determine risk factors related to poor treatment outcomes, and adjusted relative risk(RR) was considered significant at p < 0.05.

RESULTS: Overall database quality was 93.7% with uniqueness 100%, data-completeness 82.5%, consistency 97% and validity 95.1%. A total of 567 DR-TB cases were reported, with median age of 34 (1-80) years, male-to-female sex ratio (3:2). Cases were classified as 19(3.4%) RR-TB, 536(94.6%) MDR-TB, 7(1.3%) pre-XDR-TB, and 4(0.7%) XDR-TB. Case-reporting increased from 2013, reaching their peak in 2018. The overall treatment refusal rate was 123(11.9%) and treatment outcomes of 270(60.8%) cured, 116(26.4%) completed, 32(7.2%) deaths, 19(4.3%) lost-to-follow-up, and 6(1.4%) failure were recorded. We identified 84 dead (CFR:14.8%) amongst whom 52(62%) refused treatment, 17(20%) occurred during the first month of therapy and 13(15.5%) HIV-TB co-infected. Male gender [p = 0.006, RR = 2.5 (95% CI: 1.3-4.7)], HIV positive status [p = 0.012, RR = 2.1 (95% CI: 1.2-3.7)], and previous DR-TB status [p = 0.02, RR = 3.9 (95% CI: 1.3-12.0)] were statistically associated to poor treatment outcomes.

CONCLUSION: In the Littoral Region-Cameroon, cases of DR-TB increased from 2013, reaching their peak in 2018 befor dropping right up to 2022. RR-TB, MDR-TB, Pre-XDR-TB and XDR-TB represented 3.4%, 94.6%, 1.3% and 0.7% of all reported DR-TB cases. Overall, DR-TB treatment success rate was 87.2%. Male-gender, HIV-positive status, and previous DR-TB are associated with poor TB treatment outcomes. We recommend universal drug susceptibility testing to ensure early/maximum DR-TB case-detection and proper pre-treatment counselling to limit the high death rates and anti-TB treatment refusal rates which are setbacks from achieving end-TB strategies.

PMID:39558329 | DOI:10.1186/s12889-024-20585-8

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Inverted U-shaped association between total testosterone with bone mineral density in men over 60 years old

BMC Endocr Disord. 2024 Nov 18;24(1):249. doi: 10.1186/s12902-024-01780-5.

ABSTRACT

BACKGROUND: Aging often leads to changes in hormone levels, particularly testosterone, which is thought to significantly affect bone health in older males.

OBJECTIVE: This study aimed to explore the link between testosterone levels and bone mineral density in men aged 60 and above.

METHODS: Data from the National Health and Nutrition Examination Survey 2013-2014 were used. Weighted multivariable linear regression models were employed to study the association between testosterone and bone mineral density. Furthermore, a weighted generalized additive model and smooth curve fitting were used to address potential nonlinear patterns in the data.

RESULTS: The analysis included 621 elderly men. After accounting for various factors, the study uncovered a Inverted U-shaped correlation between testosterone levels and femoral neck density. Notably, a turning point was identified at the testosterone level of 406.4 ng/dL. Further examination, using different models, showed that testosterone levels in the third quartile (group Q3) were positively linked to bone density. However, contrasting trends were observed in the first (group Q1) and fourth quartiles (group Q4), where testosterone levels displayed a negative relationship with bone density.

CONCLUSION: The results indicate a complex interplay between testosterone levels and bone mineral density in elderly men. The U-shaped trend suggests that both low and high testosterone levels could negatively impact bone health. These findings highlight the importance of maintaining testosterone levels within an optimal range to preserve bone health in aging men.

PMID:39558326 | DOI:10.1186/s12902-024-01780-5

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The impact of direct health facility financing on MNCH service provision: results from a comparative, before-after study in Pwani Region, Tanzania

BMC Health Serv Res. 2024 Nov 18;24(1):1424. doi: 10.1186/s12913-024-11917-w.

ABSTRACT

BACKGROUND: Pwani Regional Secretariat in Tanzania implemented the Maternal, Neonatal, and Child Health Project (2016-2022) through Direct Health Facility Financing (DHFF), which allocates funds directly to health facilities. This study assessed the impact of the six-year DHFF project in Pwani region.

METHODS: The study utilised District Health Information Software 2 data from 18 intervention health facilities in Pwani region. Control groups comprised an equal number of facilities from Pwani and Dodoma regions where the project was not implemented. Key indicators assessed included ‘ANC 4 + Rate (%)’, ‘Percentage of Mothers tested for Anaemia during ANC’, ‘Caesarean Section Delivery Rate (%)’, ‘Percentage of Mothers and Newborns receiving PNC services within 48 hours’, ‘Delivery Complication Rate (%)’, and ‘SBA Delivery Rate (%)’ which are associated with the project interventions. The impact of the project was analysed using a paired sample t-test comparing baseline and endline data. We evaluated the significance of the dependent variables using one-way ANOVA with control groups, with the Tukey-Kramer test for post hoc analysis. Chi-square test assessed the significance of Caesarean Section Delivery Rate and the relationship between variables and health facility conditions. Pearson correlation test was used for significance between funding size and the change of MNCH variables. Statistical significance at 0.05 was calculated.

RESULTS: The project showed limited positive impacts, only in the ‘Percentage of Mothers tested for Anaemia during ANC’ (****p < 0.0001), ‘Percentage of Newborns receiving PNC within 48 hours’ (**p = 0.0095), and ‘SBA Delivery Rate’ (***p = 0.0043). The health facility assessment identified positively influencing factors on service delivery, such as facility type (*p = 0.0347), distance to the facility (****p < 0.0001), and internet connectivity (*p = 0.0186). We found that the project did not improve most MNCH indicators, including the CEmONC coverage (χ2 = 2.82, p = 0.2448, df = 2), which was known to be the leading outcome.

CONCLUSION: The project had limited impacts on MNCH outcomes due to various factors. While the health facility assessment highlighted positive influences on service delivery, significant areas for improvement remain, including referral systems and infrastructure. Operational research findings indicate that the effectiveness of the DHFF could be enhanced by refining its management and governance structures.

PMID:39558315 | DOI:10.1186/s12913-024-11917-w