Tag: nevin manimala

Am J Gastroenterol. 2024 Jun 1;119(6):1177-1180. doi: 10.14309/ajg.0000000000002819. Epub 2024 Apr 22.

ABSTRACT

INTRODUCTION: Obesity is associated with cancer, including gastrointestinal (GI). Data from low (LICs) and lower-middle-income countries (MICs) are limited.

METHODS: We utilized data from the Global Burden of Disease Study 2019 to determine the mortality from GI cancer risk of high body mass index (BMI) in these countries.

RESULTS: Mortality rates of GI cancers from high BMI increased in LICs and lower MICs, while burdens decreased or remained stable in high and middle-income countries.

DISCUSSION: The GI cancer-related burden from high BMI increased in LICs and lower MICs, necessitating a concerted effort to tackle the obesity pandemic.

PMID:38900306 | DOI:10.14309/ajg.0000000000002819

Clin Exp Med. 2024 Jun 20;24(1):133. doi: 10.1007/s10238-024-01401-4.

ABSTRACT

This study aimed to investigate the serum and expression levels of C-X-C motif chemokine ligand 9 (CXCL9), CXCL10, CXCL11, and CXC receptor 3 (CXCR3) in minor salivary glands (MSGs) of patients with primary Sjögren’s syndrome (pSS), and to explore their correlations with clinical parameters. Serum samples from 49 patients diagnosed with pSS, 33 patients with rheumatoid arthritis (RA), and 30 healthy controls (HCs) were collected for measurements of CXCL9, CXCL10, CXCL11, and CXCR3. Additionally, CXCL levels in the MSG tissues were measured in 41 patients who underwent MSG biopsy. Correlations between CXCL and CXCL/CXCR levels in serum/MSG tissues and clinical factors/salivary scintigraphy parameters were analyzed. Serum CXCL11 and CXCR3 showed statistically significant differences among patients with pSS and RA and HCs (serum CXCL11, pSS:RA:HC = 235.6 ± 500.1 pg/mL:90.0 ± 200.3 pg/mL:45.9 ± 53.6 pg/mL; p = 0.041, serum CXCR3, pSS:RA:HC = 3.27 ± 1.32 ng/mL:3.29 ± 1.17 ng/mL:2.00 ± 1.12 ng/mL; p < 0.001). Serum CXCL10 showed a statistically significant difference between pSS (64.5 ± 54.2 pg/mL) and HCs (18.6 ± 18.1 pg/mL, p < 0.001), while serum CXCL9 did not exhibit a significant difference among the groups. Correlation analysis of clinical factors revealed that serum CXCL10 and CXCL11 levels positively correlated with erythrocyte sedimentation rate (r = 0.524, p < 0.001 and r = 0.707, p < 0.001, respectively), total protein (r = 0.375, p = 0.008 and r = 0.535, p < 0.001, respectively), globulin (r = 0.539, p < 0.001 and r = 0.639, p < 0.001, respectively), and European Alliance of Associations for Rheumatology SS Disease Activity Index (r = 0.305, p = 0.033 and r = 0.321, p = 0.025). Additionally, serum CXCL10 negatively correlated with the Schirmer test score (r = – 0.354, p = 0.05), while serum CXCL11 positively correlated with the biopsy focus score (r = 0.612, p = 0.02). In the MSG tissue, the percentage of infiltrating CXCL9-positive cells was highest (75.5%), followed by CXCL10 (29.1%) and CXCL11 (27.9%). In the correlation analysis, CXCL11-expressing cells were inversely related to the mean washout percentage on salivary gland scintigraphy (r = – 0.448, p = 0.007). Our study highlights distinct serum and tissue chemokine patterns in pSS, emphasizing CXCL9’s potential for early diagnosis. This suggests that CXCL10 and CXCL11 are indicators of disease progression, warranting further investigation into their roles in autoimmune disorders beyond pSS.

PMID:38900301 | DOI:10.1007/s10238-024-01401-4

J Nurs Educ. 2024 Jun;63(6):349-355. doi: 10.3928/01484834-20240207-05. Epub 2024 Jun 1.

ABSTRACT

BACKGROUND: Nursing education research and anecdotal literature has revealed that undergraduate nursing students report anxiety related to clinical practice. Most published studies have focused on the effectiveness of interventions to reduce anxiety; only a few identify specific sources of clinical practice anxiety.

METHOD: We conducted an integrative literature review to understand the sources of nursing students’ practice-related anxiety and how this anxiety has been measured.

RESULTS: We classified sources of practice-related anxiety into nine themes grouped into five categories: consequences of making a mistake; fear of the unknown; incivility of staff members or teachers; threat to self-concept, image, or health; and theory-practice gap. Practice-related anxiety was measured quantitatively with various surveys and qualitatively using semistructured individual or group interviews and students’ journal entries.

CONCLUSION: Different sources of practice-related anxiety likely require distinct interventions. Further research is recommended to identify effective interventions to reduce anxiety related to each of the identified themes. [J Nurs Educ. 2024;63(6):349-355.].

PMID:38900270 | DOI:10.3928/01484834-20240207-05

J Nurs Educ. 2024 Jun;63(6):373-379. doi: 10.3928/01484834-20240404-05. Epub 2024 Jun 1.

ABSTRACT

BACKGROUND: This study examined the phenomenon of prelicensure nursing students caring for culturally diverse patients.

METHOD: Individual interviews were conducted with undergraduate nursing students using a hermeneutic phenomenological approach. Qualitative research experts conducted the interviews, transcribed the data, and followed van Manen’s methodology for analysis.

RESULTS: Eleven nursing students participated in the study. Data were collected from April to August 2022. The average length of the student interviews was 32 minutes. Four themes were identified: (1) communication issues; (2) access to care; (3) nurse background; and (4) trust and respect.

CONCLUSION: This study highlights the importance of caring for culturally diverse patients. Policymakers and health care leaders can use the findings to support legislative proposals for enhancing culturally diverse patient safety and health equity. Based on these findings, nurse educators and preceptors can adapt their clinical teaching approaches accordingly, and nurse managers can benefit from the results when hiring new graduate nurses. [J Nurs Educ. 2024;63(6):373-379.].

PMID:38900269 | DOI:10.3928/01484834-20240404-05

J Nurs Educ. 2024 Jun;63(6):394-398. doi: 10.3928/01484834-20240404-08. Epub 2024 Jun 1.

ABSTRACT

BACKGROUND: The mental health of students and faculty has become a growing issue in academia. Faculty need to provide role-modeling early in nursing programs to enhance psychological well-being for future nurses that will have lasting effects throughout their careers.

METHOD: A total of 29 faculty members participated in a descriptive study investigating types of self-care goals and how they could be achieved by College of Nursing faculty during their annual performance appraisal.

RESULTS: Seventy-three percent of respondents reported they anticipated that achieving these self-care goals would enhance their faculty role. Further, the respondents associated achievement of self-care goals as a way to improve their faculty performance.

CONCLUSION: Since every individual has a unique perspective of the world, a self-care approach that works for one person might not work for another. Self-care goals should therefore be tailored to the unique needs and perspectives of each person. [J Nurs Educ. 2024;63(6):394-398.].

PMID:38900266 | DOI:10.3928/01484834-20240404-08

J Nurs Educ. 2024 Jun;63(6):347-348. doi: 10.3928/01484834-20240513-05. Epub 2024 Jun 1.

NO ABSTRACT

PMID:38900265 | DOI:10.3928/01484834-20240513-05

Curr HIV Res. 2024 Jun 10. doi: 10.2174/011570162X311238240603042806. Online ahead of print.

ABSTRACT

INTRODUCTION/OBJECTIVES: Different ART (antiretroviral therapy) options may affect the risk of osteopenia/osteoporosis in people living with HIV (PLWH) having increased life expectancy. Current guidelines recommend bone mineral density (BMD) measurement only in patients at risk. In our study, we investigated the prevalence of osteopenia/osteoporosis and associated risk factors in naive patients not receiving ART.

METHODS: This study included 116 newly diagnosed, ART naive HIV-positive patients who were studied retrospectively. Vitamin D level, BMD measurement, CD4 and CD8 count, CD4/CD8 ratio, HIV RNA level, body mass index and other risk parameters of ART naive patients were included in our study.

RESULTS: Of 116 patients, 103 were male and 13 female. 47.4% (osteoporosis in 4.3%, osteopenia in 43.1%) of patients had osteopenia/osteoporosis. The patients with osteopenia/osteoporosis had older age (39.2±11.0 vs 32.0±8.6, p=0.0001), lower vitamin D levels (16.0±5.0 vs 24.4±6.3, p=0.0001), lower BMI (body mass index) (23.0±4.0 vs 24.6±4.6 p<0.05), lower CD4 and CD8 counts (405.1±885.0 vs 467.3± 695.1; 849.9570.4 vs 1012.0±629.4 respectively, p<0.05). 41.8% had CD4 count ≤200/μL (vs 18.0%, p=0.005). No statistically significant differences were observed in terms of gender distribution, smoking, alcohol and drug use, comorbidities and, additional drug use and HIV RNA >100 000 copies/ml. In multivariate analysis, age and vitamin D level were significant and independent (p<0.05) risk factors with osteoporosis/osteopenia.

CONCLUSION: Being over 40 years of age, CD4 count ≤200/μL, vitamin D level <20 ng/mL and low BMI are the most important risk factors for osteopenia/osteoporosis in ART naive patients. Among these parameters, age and vitamin D level were significant and independent risk factors. These factors may guide the determination of the need for dual-energy x-ray absorptiometry (DXA) testing in ART naive patients and drug choices in the treatment plan.

PMID:38899524 | DOI:10.2174/011570162X311238240603042806

Elife. 2024 Jun 20;12:RP88648. doi: 10.7554/eLife.88648.

ABSTRACT

Animals can use a repertoire of strategies to navigate in an environment, and it remains an intriguing question how these strategies are selected based on the nature and familiarity of environments. To investigate this question, we developed a fully automated variant of the Barnes maze, characterized by 24 vestibules distributed along the periphery of a circular arena, and monitored the trajectories of mice over 15 days as they learned to navigate towards a goal vestibule from a random start vestibule. We show that the patterns of vestibule visits can be reproduced by the combination of three stochastic processes reminiscent of random, serial, and spatial strategies. The processes randomly selected vestibules based on either uniform (random) or biased (serial and spatial) probability distributions. They closely matched experimental data across a range of statistical distributions characterizing the length, distribution, step size, direction, and stereotypy of vestibule sequences, revealing a shift from random to spatial and serial strategies over time, with a strategy switch occurring approximately every six vestibule visits. Our study provides a novel apparatus and analysis toolset for tracking the repertoire of navigation strategies and demonstrates that a set of stochastic processes can largely account for exploration patterns in the Barnes maze.

PMID:38899521 | DOI:10.7554/eLife.88648

Appl Immunohistochem Mol Morphol. 2024 Jun 20. doi: 10.1097/PAI.0000000000001207. Online ahead of print.

ABSTRACT

Extranodal marginal zone lymphoma (EMZL) is the most common subtype of ocular lymphomas. Diffuse large B-cell lymphoma (DLBCL) and EMZL with large-cell transformation present diagnostic challenges. Radiotherapy is the standard treatment for ocular lymphomas, but complications and relapse are common. Diagnostic utility in challenging cases, as well as treatment options using immune checkpoint inhibitors, are unclear in ocular lymphomas. We herein investigated the PD-1, PD-L1, and IDO1 staining patterns in 20 cases of ocular lymphomas, including EMZL (n=14), EMZL with increased large cells (n=2), and DLBCL (n=4). PD-1, PD-L1, and IDO1 staining was not detected in lymphoma cells in any cases but was observed within the tumor microenvironment in all cases. Positivity for PD-1, PD-L1, and IDO1 in inflammatory cells was seen either intratumorally or peritumorally. In all 6 cases with significantly more large B cells, the density of PD-1, PD-L1, and IDO1 expression in the tumor microenvironment was higher than that of the remaining 14 cases without large B cells (P-value<0.0001), whereas other clinicopathologic features showed no statistical correlation. Increased expression of PD-1, PD-L1, and IDO1 in the inflammatory milieu in cases with large cells may provide diagnostic utility in small biopsies as well as therapeutic potential.

PMID:38899518 | DOI:10.1097/PAI.0000000000001207

Stat Med. 2024 Jun 20. doi: 10.1002/sim.10157. Online ahead of print.

ABSTRACT

Meta-analysis is an essential tool to comprehensively synthesize and quantitatively evaluate results of multiple clinical studies in evidence-based medicine. In many meta-analyses, the characteristics of some studies might markedly differ from those of the others, and these outlying studies can generate biases and potentially yield misleading results. In this article, we provide effective robust statistical inference methods using generalized likelihoods based on the density power divergence. The robust inference methods are designed to adjust the influences of outliers through the use of modified estimating equations based on a robust criterion, even when multiple and serious influential outliers are present. We provide the robust estimators, statistical tests, and confidence intervals via the generalized likelihoods for the fixed-effect and random-effects models of meta-analysis. We also assess the contribution rates of individual studies to the robust overall estimators that indicate how the influences of outlying studies are adjusted. Through simulations and applications to two recently published systematic reviews, we demonstrate that the overall conclusions and interpretations of meta-analyses can be markedly changed if the robust inference methods are applied and that only the conventional inference methods might produce misleading evidence. These methods would be recommended to be used at least as a sensitivity analysis method in the practice of meta-analysis. We have also developed an R package, robustmeta, that implements the robust inference methods.

PMID:38899515 | DOI:10.1002/sim.10157