Tag: nevin manimala

JAMA Netw Open. 2024 Apr 1;7(4):e246235. doi: 10.1001/jamanetworkopen.2024.6235.

ABSTRACT

IMPORTANCE: Angiosarcoma is an aggressive vascular malignant neoplasm presenting either as a primary or secondary cancer, often arising after radiotherapy or in the context of preexisting lymphedema. Comprehensive data describing its incidence and presentation patterns are needed.

OBJECTIVE: To describe the incidence, presenting characteristics, and change over time of angiosarcoma in the US.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective cross-sectional study used data from the US Cancer Statistics (USCS) National Program of Cancer Registries-Surveillance, Epidemiology, and End Results Combined Database, which captures more than 99% of newly diagnosed cancers in the US. The study included all 19 289 patients in the US with a new diagnosis of angiosarcoma between 2001 and 2020 captured in the USCS database. Statistical analysis was performed from June to September 2023.

MAIN OUTCOMES AND MEASURES: Incidence of angiosarcoma, demographics of patients with angiosarcoma, and extent of disease at presentation.

RESULTS: The study included 19 289 patients (median age, 71 years [IQR, 59-80 years]; 10 506 women [54.5%]) with a new diagnosis of angiosarcoma. The US incidence of angiosarcoma doubled between 2001 (657 cases) and 2019 (1312 cases), reflecting both an increase in the adjusted incidence rate of 1.6% per year (P = .001), to 3.3 cases per 1 000 000 person-years (95% CI, 3.1-3.5 cases per 1 000 000 person-years), and an increase in the population at risk. In 2020, the reported incidence rate (3.0 cases per 1 000 000 person-years) and cases of angiosarcoma (n = 1159) were modestly lower than in 2019. Overall, 72.3% of cases of angiosarcoma (n = 13 955) were cutaneous, subcutaneous, or breast angiosarcomas; 24.4% were visceral (n = 4701); and 3.3% were located in unknown or rare primary sites (n = 633). Secondary breast and chest wall angiosarcomas among women represented the largest contribution to increasing incidence. Among breast angiosarcomas, 99.2% (2684 of 2705) were in women and 71.9% (1944 of 2705) were secondary. A total of 80.4% of chest wall or thorax cases among women (1861 of 2316) were secondary vs 26.5% among men (112 of 422), and 63.9% of upper extremity cases among women (205 of 321) were secondary vs 26.8% (56 of 209) among men (P = .001). Rates of secondary angiosarcoma in the abdomen and lower extremities were similar between men and women. The incidence rate of visceral angiosarcoma was also found to be increasing (1.5% per year; P = .001).

CONCLUSIONS AND RELEVANCE: This cross-sectional study describes angiosarcoma presentation patterns and incidence rates in the US over a 20-year period and shows that the number of cases in men and women increased, with the greatest increase among women with secondary angiosarcoma of the chest, breast, and upper extremity. These data increase awareness of a rare but highly morbid disease and highlight the need for improved early detection of angiosarcoma among patients at high risk, such as women with a history of breast cancer.

PMID:38607625 | DOI:10.1001/jamanetworkopen.2024.6235

JAMA Netw Open. 2024 Apr 1;7(4):e246448. doi: 10.1001/jamanetworkopen.2024.6448.

ABSTRACT

IMPORTANCE: Nonheterosexual and gender-nonconforming (GNC) individuals tend to report adverse childhood experiences (ACEs) more frequently compared with heterosexual and gender-conforming individuals, and individuals who have experienced ACEs, identify as nonheterosexual, or exhibit moderate to high levels of GNC are more prone to engaging in problematic smartphone use (PSU). However, there is limited school-based data among adolescents regarding this matter.

OBJECTIVES: To explore the associations between ACEs and PSU among adolescents across different sexual orientation and gender expression groups.

DESIGN, SETTING, AND PARTICIPANTS: Using data from the 2021 School-Based Chinese Adolescents Health Survey, this cross-sectional study includes participants from 288 public high schools across 8 provinces in China. Statistical analysis was performed from October 2023 to February 2024.

EXPOSURES: Data on ACEs, sexual orientations, and gender expressions (high, moderate, and low GNC) were collected.

MAIN OUTCOMES AND MEASURES: PSU was assessed using the 10-item Smartphone Addiction Scale-Short Version (SAS-SV). Weighted linear, logistic, or Poisson regression models were used.

RESULTS: Among the 85 064 adolescents included (mean [SD] age, 14.92 [1.77] years), 42 632 (50.1%) were female, 70 157 (83.2%) identified as Han Chinese, and 14 208 (16.8) identified as other ethnicities (Miao, Hui, Yi, Dai, and other ethnic groups). The prevalence of PSU among participants was 35.4%. Weighted Poisson regression models indicated that the interaction between GNC and ACE was significant (adjusted prevalence ratio [APR], 0.98; 95% CI, 0.97-0.99). Further stratified analysis demonstrated homosexual adolescents who experienced 4 or more ACEs showed a significantly increased prevalence of PSU (APR, 1.79; 95% CI, 1.64-1.96). Similarly, a markedly higher prevalence of PSU was observed among bisexual individuals with 4 or more ACEs (APR, 1.60; 95% CI, 1.41-1.80). Regarding gender expression categories, a significantly higher prevalence of PSU was noted among high GNC adolescents with 4 or more ACEs (APR, 1.78; 95% CI, 1.60-1.98) compared with low GNC adolescents without ACEs. Furthermore, experiencing any 3 ACE categories (abuse, neglect, and household dysfunction) was associated with an increased prevalence of PSU across different sexual orientation and gender expression subgroups.

CONCLUSIONS AND RELEVANCE: In this cross-sectional study, the amalgamation of elevated ACE scores with nonheterosexual orientations or GNC identities was significantly associated with increased PSU prevalence. These findings underscore that preventing ACEs may be beneficial in mitigating PSU among adolescents, particularly for nonheterosexual adolescents and those with high levels of GNC.

PMID:38607622 | DOI:10.1001/jamanetworkopen.2024.6448

Anal Sci. 2024 Apr 12. doi: 10.1007/s44211-024-00562-2. Online ahead of print.

ABSTRACT

This research developed a colorimetric assay for semi-quantitative curcumin detection. The screening test was performed using a ferric chloride to form a brownish color which was further used to evaluate the amount of curcumin in the turmeric powder samples. The quantitative assay was performed based on the color intensity of the curcumin target using a smartphone digital image colorimetry with a developed lightbox constructed with a white light-emitting diodes (LED) light source as the measurement device. Images in red, green, and blue (RGB) color were processed to obtain relevant colors from the image and the color values were used to analyze curcumin concentrations. The intensity of the ΔB was correlated to the concentration of curcumin with high sensitivity. The method showed a linear range between 0.25 and 5 mg L^-1 with the LOD and LOQ of 0.12 and 0.41 mg L^-1, respectively. Sample analysis was carried out in turmeric powders. Curcumin in turmeric powder samples was simply extracted using acetonitrile followed by dilution 100 times for sample preparation. The accuracy was tested by spiking 0.25, 1.00, and 4.00 mg L^-1 of standard curcumin into the turmeric sample solution. The average percentage recoveries were acceptable in all samples (90-104%). The method was validated by comparing the results obtained from the proposed method and high-performance liquid chromatography (HPLC). There was no statistically significant difference between the two methods (P = 0.05).

PMID:38607598 | DOI:10.1007/s44211-024-00562-2

Discov Oncol. 2024 Apr 12;15(1):114. doi: 10.1007/s12672-024-00976-4.

ABSTRACT

BACKGROUND: Circulating tumor cell (CTC) detection is one form of liquid biopsy. It is a novel technique that is beginning to be applied in the field of thyroid cancer. The present study was designed to evaluate the diagnostic value of CTCs in patients with thyroid cancer.

METHODS: A total of 1478 patients were retrospectively analyzed and divided into malignant group (n = 747) and benign group (n = 731). Peripheral blood was collected, and CTCs were enriched and quantified before surgery. The baseline data of the two groups were matched by Propensity Score Matching (PSM). Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficiency of different indicators for thyroid cancer. The malignant group before PSM was further divided into subgroups according to the BRAF V600E mutation and lymphatic metastasis (N stage), and the number of CTCs in different subgroups was compared.

RESULTS: After 1:1 PSM, baseline characteristics of the malignant group and benign group were matched and assigned 315 cases in each group. The number of CTCs and the TPOAb values were comparable in the two groups (p > 0.05). The TgAb values [1.890 (1.110 – 16.010) vs 1.645 (1.030 – 7.073) IU/mL, p = 0.049] were significantly higher in the malignant group than in the benign group. After PSM, ROC analyses showed that the areas under the curve (AUCs) of CTC, TgAb and ultrasound were 0.537 (sensitivity 65.6%, specificity 45.8%), 0.546 (sensitivity 40.0%, specificity 70.8%) and 0.705 (sensitivity 77.1%, specificity 63.2%), respectively. The AUCs of the combined detection of ‘CTC + ultrasound’ (combine 1) and the combined detection of ‘CTC + TgAb + ultrasound’ (combine 2) were 0.718 (sensitivity 79.3%, specificity 61.7%) and 0.724 (sensitivity 78.0%, specificity 63.3%), respectively. The AUC of ultrasound was significantly higher than CTC (p < 0.001). There was no statistically significant difference in AUC between combination 1 and ultrasound, and between combination 2 and ultrasound (p > 0.05). The number of CTCs between the N0 and N1 subgroups, and between the BRAF mutant and BRAF wild subgroups was comparable (p > 0.05).

CONCLUSIONS: As an emerging and noninvasive testing tool, the efficacy of CTCs in diagnosing thyroid cancer is limited.

PMID:38607590 | DOI:10.1007/s12672-024-00976-4

Eur J Clin Microbiol Infect Dis. 2024 Apr 12. doi: 10.1007/s10096-024-04818-7. Online ahead of print.

ABSTRACT

PURPOSE: Acinetobacter baumannii (Ab) is a Gram-negative opportunistic bacterium responsible for nosocomial infections or colonizations. It is considered one of the most alarming pathogens due to its multi-drug resistance and due to its mortality rate, ranging from 34 to 44,5% of hospitalized patients. The aim of the work is to create a predictive mortality model for hospitalized patient with Ab infection or colonization.

METHODS: A cohort of 140 sequentially hospitalized patients were randomized into a training cohort (TC) (100 patients) and a validation cohort (VC) (40 patients). Statistical bivariate analysis was performed to identify variables discriminating surviving patients from deceased ones in the TC, considering both admission time (T0) and infection detection time (T1) parameters. A custom logistic regression model was created and compared with models obtained from the “status” variable alone (Ab colonization/infection), SAPS II, and APACHE II scores. ROC curves were built to identify the best cut-off for each model.

RESULTS: Ab infection status, use of penicillin within 90 days prior to ward admission, acidosis, Glasgow Coma Scale, blood pressure, hemoglobin and use of NIV entered the logistic regression model. Our model was confirmed to have a better sensitivity (63%), specificity (85%) and accuracy (80%) than the other models.

CONCLUSION: Our predictive mortality model demonstrated to be a reliable and feasible model to predict mortality in Ab infected/colonized hospitalized patients.

PMID:38607579 | DOI:10.1007/s10096-024-04818-7

Abdom Radiol (NY). 2024 Apr 12. doi: 10.1007/s00261-024-04292-x. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the role of conventional diffusion weighted imaging, diffusion kurtosis imaging (DKI), and intravoxel incoherent motion (IVIM) in distinguishing benign from malignant adnexal masses.

METHODS: 38 patients with 45 adnexal masses were enrolled in this prospective study and assessed with multiparametric MRI, including the IVIM-DKI sequence, on a 3 T MRI system. The mean apparent diffusion coefficient (ADC) from conventional DWI, the apparent diffusion coefficient derived from DKI (D_app), the apparent kurtosis coefficient (K_app), true diffusion coefficient (D_t), perfusion fraction (f) and pseudo-diffusion coefficient (D_p) were measured.

RESULTS: The mean ADC, D_app, and D_t were significantly higher in benign adnexal masses than in malignant adnexal masses (p < 0.001). f and D_p were also significantly higher in benign adnexal masses, with p values of 0.026 and 0.002, respectively. K_app was higher in malignant masses (p < 0.001). Among mean ADC, D_app, and D_t, mean ADC had the highest area under the curve (AUC) of 0.885. However, no statistically significant differences were observed between the ROCs of various diffusion parameters.

CONCLUSION: The mean ADC, D_app, and K_app are useful parameters in discriminating between benign and malignant adnexal masses. D_t derived from IVIM also helps in distinguishing benign and malignant adnexal masses; however, no incremental role of IVIM and DKI over ADC could be identified in our study.

PMID:38607571 | DOI:10.1007/s00261-024-04292-x

Curr Pain Headache Rep. 2024 Apr 12. doi: 10.1007/s11916-024-01252-4. Online ahead of print.

ABSTRACT

PURPOSE OF THE REVIEW: Acute pain management remains a challenge and postoperative pain is often undermanaged despite many available treatment options, also including cannabinoids.

RECENT FINDINGS: In the light of the opioid epidemic, there has been growing interest in alternative care bundles for pain management, including cannabinoids as potential treatment to decrease opioid prescribing. Despite the lack of solid evidence on the efficacy of cannabinoids, their use among patients with pain, including those using opioids, is currently increasing. This use is supported by data suggesting that cannabinoids could potentially contribute to a better pain management and to a reduction in opioid doses while maintaining effective analgesia with minimum side effects. The scientific basis for supporting the use of cannabis is extensive, although it does not necessarily translate into relevant clinical outcomes. The use of cannabinoids in acute pain did not always consistently show statistically significant results in improving acute pain. Large randomized, controlled trials evaluating diverse cannabis extracts are needed in different clinical pain populations to determine safety and efficacy.

PMID:38607548 | DOI:10.1007/s11916-024-01252-4

Trop Anim Health Prod. 2024 Apr 12;56(3):120. doi: 10.1007/s11250-024-03962-8.

ABSTRACT

The current study evaluated the effects of supplementing cassava root silage (CRS) to dairy cows grazing on Megathyrsus maximus cv Mombasa on nutrient intake and digestibility, as well as on milk production and composition. Ten primiparous Girolando cows with average body weight ± (SEM) of 373.45 ± (63.55) kg were used in a replicated 5 × 5 Latin square. Animals were subjected to five treatments: (I) grazing cows without supplementation (WCS); (II) grazing cows provided with 5 kg DM of supplement without CRS (0 g/kg DM of CRS) or including (III) 260, (IV) 520, and (V) 780 g/kg DM of CRS. Statistical analyses were performed using the PROC MIXED of SAS with significance at P < 0.05. Intake of neutral detergent fiber (NDF) and ether extract decreased (P < 0.01), while intake of non-fiber carbohydrates increased (P < 0.01), with increased CRS in the diets. Total DM intake and digestibility of DM, and digestibility of nutritional components were lower (P < 0.03) in WCS animals compared to supplemented animals, except for intake and digestibility of NDF, which was the opposite. Milk yield (MY) and fat corrected milk (FCM), as well as all milk components were unaffected (P > 0.05) by CRS inclusion. In contrast, MY, FCM, protein, lactose, casein, and non-fat milk solids (NFMS) were greater for animals that received supplementation (P < 0.05), compared to animals WCS. Milk fat and total dry extract (TMS) did not differ (P > 0.11) between two groups. In conclusion, CRS may be a potential corn meal replacer in the supplement of dairy cows under tropical conditions.

PMID:38607525 | DOI:10.1007/s11250-024-03962-8

Pharmacoeconomics. 2024 Apr 12. doi: 10.1007/s40273-024-01374-y. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Decision models for health technology assessment (HTA) are largely submitted to HTA agencies using commercial software, which has known limitations. The use of the open-source programming language R has been suggested because of its efficiency, transparency, reproducibility, and ability to consider complex analyses. However, its use in HTA remains limited. This qualitative study aimed to explore the main reasons for this slow uptake of R in HTA and identify tangible facilitators.

METHODS: We undertook two semi-structured focus group discussions with 24 key stakeholders from government agencies, consultancy, pharmaceutical companies, and academia. Two 1.5-hour discussions reflected on barriers identified in a previous study and highlighted additional barriers. Discussions were recorded and semi-transcribed, and data were organized and summarized into key themes.

RESULTS: Human resources constraints were identified as a key barrier, including a lack of training, prioritization and collaboration, and resistance to change. Another key barrier was the lack of acceptance, or clear guidance, around submissions in R by HTA agencies. Participants also highlighted a lack of communication around accepted packages and decision model structures, and between HTA agencies on standard decision modeling structures.

CONCLUSIONS: There is a need for standardization, which can facilitate decision model sharing, coding homogeneity, and improved country adaptations. The creation of training materials and tailored workshops was identified as a key short-term facilitator. Increased communication and engagement of stakeholders could also facilitate the use of R by identifying needs and opportunities, encouraging HTA agencies to address structural barriers, and increasing incentives to use R.

PMID:38607519 | DOI:10.1007/s40273-024-01374-y

Environ Monit Assess. 2024 Apr 12;196(5):443. doi: 10.1007/s10661-024-12569-3.

ABSTRACT

This study aims to assess the extent of heavy metals (HMs) pollution in soil and identify its potential sources using single and integrated pollution index calculations, and multivariate statistical analysis. The HM concentrations of soil samples were analyzed using ICP-MS. The concentrations (mg/kg) of arsenic (As) ranged from 2.8 to 208.1, cadmium (Cd) from 0.1 to 0.3, cobalt (Co) from 1.9 to 20.5, copper (Cu) from 3.7 to 17.7, nickel (Ni) from 14.7 to 110.6, and lead (Pb) from 6.7 to 37.3. High levels of As contents and physicochemical parameters were found in the northeastern parts of the study area, while levels of other HMs were high in the remaining parts. The HM contents of some soil samples exceeded the average values of basalt and limestone in the study area, as well as the upper, bulk, and lower continental crusts, shale, and soil (worldwide). Multiple index methods were used to assess the pollution risk, and it was determined that some soil samples were moderately to considerably contaminated with varying levels of As, Cd, Co, Ni, and Pb. Multivariate statistical analyses provided that the source of HMs contamination in the soil was a result of geogenic and/or anthropogenic activities. Geogenic sources were associated with weathering rock units, while anthropogenic sources were linked to industrial activities, traffic emissions, and agricultural applications. The findings are useful for detecting contamination by HMs in soil, and they could contribute to future monitoring programs to prevent soil contamination and protect the health of living organisms.

PMID:38607502 | DOI:10.1007/s10661-024-12569-3