Tag: nevin manimala

Ren Fail. 2024 Dec;46(1):2353341. doi: 10.1080/0886022X.2024.2353341. Epub 2024 Jun 4.

ABSTRACT

This systematic review aimed to statistically profile the medication burden and associated influencing factors, and outcomes in patients with dialysis-dependent chronic kidney disease (DD-CKD). Studies of medication burden in patients with DD-CKD in the last 10 years from 1 January 2013 to 31 March 2024 were searched from PubMed, Embase, and Cochrane databases. Newcastle-Ottawa Scale (NOS) or Agency for Healthcare Research and Quality (AHRQ) methodology checklist was used to evaluate quality and bias. Data extraction and combining from multiple groups of number (n), mean, and standard deviation (SD) were performed using R programming language (version4.3.1; R Core Team, Vienna, Austria). A total of 10 studies were included, and the results showed a higher drug burden in patients with DD-CKD. The combined pill burden was 14.57 ± 7.56 per day in hemodialysis (HD) patients and 14.63 ± 6.32 in peritoneal dialysis (PD) patients. The combined number of medications was 9.74 ± 3.37 in HD and 8 ± 3 in PD. Four studies described the various drug classes and their proportions, in general, antihypertensives and phosphate binders were the most commonly used drugs. Five studies mentioned factors associated with medication burden. A total of five studies mentioned medication burden-related outcomes, with one study finding that medication-related burden was associated with increased treatment burden, three studies finding that poor medication adherence was associated with medication burden, and another study finding that medication complexity was not associated with self-reported medication adherence. Limitations: meta-analysis was not possible due to the heterogeneity of studies.

PMID:38832502 | DOI:10.1080/0886022X.2024.2353341

J Korean Med Sci. 2024 Jun 3;39(21):e177. doi: 10.3346/jkms.2024.39.e177.

NO ABSTRACT

PMID:38832479 | DOI:10.3346/jkms.2024.39.e177

Gigascience. 2024 Jan 2;13:giae020. doi: 10.1093/gigascience/giae020.

ABSTRACT

BACKGROUND: Modern sequencing technologies offer extraordinary opportunities for virus discovery and virome analysis. Annotation of viral sequences from metagenomic data requires a complex series of steps to ensure accurate annotation of individual reads and assembled contigs. In addition, varying study designs will require project-specific statistical analyses.

FINDINGS: Here we introduce Hecatomb, a bioinformatic platform coordinating commonly used tasks required for virome analysis. Hecatomb means “a great sacrifice.” In this setting, Hecatomb is “sacrificing” false-positive viral annotations using extensive quality control and tiered-database searches. Hecatomb processes metagenomic data obtained from both short- and long-read sequencing technologies, providing annotations to individual sequences and assembled contigs. Results are provided in commonly used data formats useful for downstream analysis. Here we demonstrate the functionality of Hecatomb through the reanalysis of a primate enteric and a novel coral reef virome.

CONCLUSION: Hecatomb provides an integrated platform to manage many commonly used steps for virome characterization, including rigorous quality control, host removal, and both read- and contig-based analysis. Each step is managed using the Snakemake workflow manager with dependency management using Conda. Hecatomb outputs several tables properly formatted for immediate use within popular data analysis and visualization tools, enabling effective data interpretation for a variety of study designs. Hecatomb is hosted on GitHub (github.com/shandley/hecatomb) and is available for installation from Bioconda and PyPI.

PMID:38832467 | DOI:10.1093/gigascience/giae020

Gigascience. 2024 Jan 2;13:giae024. doi: 10.1093/gigascience/giae024.

ABSTRACT

BACKGROUND: Due to human error, sample swapping in large cohort studies with heterogeneous data types (e.g., mix of Oxford Nanopore Technologies, Pacific Bioscience, Illumina data, etc.) remains a common issue plaguing large-scale studies. At present, all sample swapping detection methods require costly and unnecessary (e.g., if data are only used for genome assembly) alignment, positional sorting, and indexing of the data in order to compare similarly. As studies include more samples and new sequencing data types, robust quality control tools will become increasingly important.

FINDINGS: The similarity between samples can be determined using indexed k-mer sequence variants. To increase statistical power, we use coverage information on variant sites, calculating similarity using a likelihood ratio-based test. Per sample error rate, and coverage bias (i.e., missing sites) can also be estimated with this information, which can be used to determine if a spatially indexed principal component analysis (PCA)-based prescreening method can be used, which can greatly speed up analysis by preventing exhaustive all-to-all comparisons.

CONCLUSIONS: Because this tool processes raw data, is faster than alignment, and can be used on very low-coverage data, it can save an immense degree of computational resources in standard quality control (QC) pipelines. It is robust enough to be used on different sequencing data types, important in studies that leverage the strengths of different sequencing technologies. In addition to its primary use case of sample swap detection, this method also provides information useful in QC, such as error rate and coverage bias, as well as population-level PCA ancestry analysis visualization.

PMID:38832466 | DOI:10.1093/gigascience/giae024

Zhejiang Da Xue Xue Bao Yi Xue Ban. 2024 Jun 4:1-8. doi: 10.3724/zdxbyxb-2023-0454. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate the effect of sinusoidal alternating electromagnetic field (SEMF) on fracture healing and its mechanism.

METHODS: Femoral fracture model was established using SPF male Wistar rats, 30 model rats were randomly divided into model control (MC) and SEMF groups with 15 rats in each group. The SEMF group was given 50 Hz 1.8 mT for 90 min every day, and the MC group was not treated. X-ray examinations were performed every two weeks to determine the formation of bone scabs in each group of rats. Three rats were sacrificed after 2 and 4 weeks of treatment in both groups. Protein was extracted from the fractured femurs, and the expression of type Ⅰ collagen (COL-1), Osterix (OSX), Runt-related transcription factor 2 (RUNX2), and vascular endothelial growth factor (VEGF) protein level was detected by immunoblotting. After 8 weeks, the femur on the operated side was taken for micro-CT scanning to observe fracture healing, angiography to observe blood vessel growth, and organs such as hearts, livers, spleens, lungs, and kidneys were taken for safety evaluation by hematoxylin-eosin staining (HE staining).

RESULTS: The bone scab scores of the SEMF group were significantly higher than those of the MC group after 2, 4, 6, and 8 weeks of treatment (all P<0.01); the fracture healing of the SEMF group was better than that of the MC group after 8 weeks, and the bone volume scores of the two groups were 0.243±0.012 and 0.186±0.008, respectively, with statistically significant differences (P<0.01); and the number of blood vessels in the SEMF group was also more than that of the MC group after 8 weeks. The results of protein blotting method showed that the protein expression of VEGF, COL-1, RUNX2, and OSX was higher in the SEMF group than in the MC group after 2 and 4 weeks of treatment (all P<0.05), and the HE staining showed that there was no abnormality in histopathological observation of examined organs in both groups.

CONCLUSIONS: SEMF can accelerate fracture healing by promoting the expression of osteogenic factors and vascular proliferation without significant adverse effects.

PMID:38832464 | DOI:10.3724/zdxbyxb-2023-0454

Rural Remote Health. 2024 Jun;24(2):8602. doi: 10.22605/RRH8602. Epub 2024 Jun 4.

ABSTRACT

INTRODUCTION: Breast cancer is the most common cause of cancer-related deaths. and early diagnosis could reduce breast cancer deaths. Therefore, health literacy is one of the most important determinants of participation in cancer screening for early diagnosis. This study aimed to determine the relationship between women’s mammography screening behaviors and health literacy levels.

METHODS: The cross-sectional study included 312 women aged 40-69 years living in a rural area. Data were collected through face-to-face interviews using a personal information form and the Turkish Health Literacy Scale (THLS-32).

RESULTS: Of the women, 28.5% had mammography in the last 2 years. Of concern was the low health literacy levels. In addition, there were significant differences in the THLS-32 subgroup scores, including the THLS-32 total score, among the mammography screening groups.

CONCLUSION: Health literacy levels of women were related to mammography screening rates. For this reason, effective intervention studies aiming to increase society’s health literacy levels may contribute to an increase in breast cancer screenings.

PMID:38832455 | DOI:10.22605/RRH8602

JBI Evid Synth. 2024 Jun 4. doi: 10.11124/JBIES-23-00340. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this systematic review is to synthesize studies on economic burden and economic impact of noncommunicable diseases (NCDs) in the World Health Organization South-East Asian Region (WHO SEAR) countries.

INTRODUCTION: WHO SEAR countries represent 8.6% of the world’s population and 75% of all deaths in this region are attributable to NCDs. In addition, there is a pattern of low government spending on health in SEAR countries, leading to a high proportion of health financing by patients’, risking impoverishment for households.

INCLUSION CRITERIA: We will consider observational (cross-sectional, cohort, and case-control) and interventional (either single arm or comparative) studies that report economic burden (direct and indirect costs, out-of-pocket expenditure) and economic impact (catastrophic health expenditure, hardship financing, impoverishment, and gross domestic product impact at individual, household, and/or country levels). This includes government surveys, surveillance, and secondary data analyses for one or more NCDs prevalent in the WHO SEAR.

METHODS: We will conduct a comprehensive search for relevant studies in databases, including PubMed (MEDLINE), Embase (Ovid), Scopus, Web of Science, Google Scholar, and gray literature with no date limits. Two independent reviewers will screen titles and abstracts, followed by full-text screening. Included studies will be critically appraised for quality. Data will be extracted accordingly and, if possible, random effects meta-analyses will be conducted on the pooled data for resource utilization and costs (including burden and impact), presenting the degree of variation between studies. The characteristics and results of the included studies will be narratively summarized with accompanying tables.

REVIEW REGISTRATION: PROSPERO CRD42023421302.

PMID:38832454 | DOI:10.11124/JBIES-23-00340

Pediatrics. 2024 Jun 4:e2024065799. doi: 10.1542/peds.2024-065799. Online ahead of print.

ABSTRACT

To identify priority areas to improve the design, conduct, and reporting of pediatric clinical trials, the international expert network, Standards for Research (StaR) in Child Health, was assembled and published the first 6 Standards in Pediatrics in 2012. After a recent review summarizing the 247 publications by StaR Child Health authors that highlight research practices that add value and reduce research “waste,” the current review assesses the progress in key child health trial methods areas: consent and recruitment, containing risk of bias, roles of data monitoring committees, appropriate sample size calculations, outcome selection and measurement, and age groups for pediatric trials. Although meaningful change has occurred within the child health research ecosystem, measurable progress is still disappointingly slow. In this context, we identify and review emerging trends that will advance the agenda of increased clinical usefulness of pediatric trials, including patient and public engagement, Bayesian statistical approaches, adaptive designs, and platform trials. We explore how implementation science approaches could be applied to effect measurable improvements in the design, conducted, and reporting of child health research.

PMID:38832441 | DOI:10.1542/peds.2024-065799

Rural Remote Health. 2024 Jun;24(2):8641. doi: 10.22605/RRH8641. Epub 2024 Jun 4.

ABSTRACT

INTRODUCTION: Despite universal health coverage and high life expectancy, Japan faces challenges in health care that include providing care for the world’s oldest population, increasing healthcare costs, physician maldistribution and an entrenched medical workforce and training system. Primary health care has typically been practised by specialists in other fields, and general medicine has only been certified as an accredited specialty since 2018. There are continued challenges to develop an awareness and acceptance of the primary health medical workforce in Japan. The impact of these challenges is highest in rural and island areas of Japan, with nearly 50% of rural and remote populations considered ‘elderly’. Concurrently, these areas are experiencing physician shortages as medical graduates gravitate to urban areas and choose medical specialties more commonly practised in cities. This study aimed to understand the views on the role of rural generalist medicine (RGM) in contributing to solutions for rural and island health care in Japan.

METHODS: This was a descriptive qualitative study. Data were collected via semi-structured interviews with 16 participants, including Rural Generalist Program Japan (RGPJ) registrars and supervisors, the RGPJ director, government officials, rural health experts and academics. Interviews were of 35-50 minutes duration and conducted between May and July 2019. Some interviews were conducted in person at the WONCA Asia-Pacific Conference in Kyoto, some onsite in hospital settings and some were videoconferenced. Interviews were recorded and transcribed. All transcripts were analysed through an inductive thematic process based on the grouping of codes.

RESULTS: From the interview analysis, six main themes were identified: (1) key issues facing rural and island health in Japan; (2) participant background; (3) local demography and population; (4) identity, perception and role of RGM; (5) RGPJ experience; and (6) suggested reforms and recommendations.

DISCUSSION: The RGPJ was generally considered to be a positive step toward reshaping the medical workforce to address the geographic inequities in Japan. While improvements to the program were suggested by participants, it was also generally agreed that a more systematic, national approach to RGM was needed in Japan. Key findings from this study are relevant to this goal. This includes considering the drivers to participating in the RGPJ for future recruitment strategies and the need for an idiosyncratic Japanese model of RGM, with agreed advanced skills and supervision models. Also important are the issues raised by participants on the need to improve community acceptance and branding of rural generalist doctors to support primary care in rural and island areas.

CONCLUSION: The RGPJ represents an effort to bolster the national rural medical workforce in Japan. Discussions from participants in this study indicate strong support to continue research, exploration and expansion of a national RGM model that is contextualised for Japanese conditions and that is branded and promoted to build community support for the role of the rural generalist.

PMID:38832438 | DOI:10.22605/RRH8641

Nucl Med Commun. 2024 Jun 3. doi: 10.1097/MNM.0000000000001867. Online ahead of print.

ABSTRACT

OBJECTIVE: This study compared the radiomic features and quantitative biomarkers of 18F-PSMA-1007 [prostate-specific membrane antigen (PSMA)] and 18F-fluorocholine (FCH) PET/computed tomography (CT) in prostate cancer patients with biochemical recurrence (BCR) enrolled in the phase 3, prospective, multicenter BIO-CT-001 trial.

METHODS: A total of 106 patients with BCR, who had undergone primary definitive treatment for prostate cancer, were recruited to this prospective study. All patients underwent one PSMA and one FCH PET/CT examination in randomized order within 10 days. They were followed up for a minimum of 6 months. Pathology, prostate-specific antigen (PSA), PSA doubling time, PSA velocity, and previous or ongoing treatment were analyzed. Using LifeX software, standardized uptake value (SUV) maximum, SUVmean, PSMA and choline total volume (PSMA-TV/FCH-TV), and total lesion PSMA and choline (TL-PSMA/TL-FCH) of all identified metastatic lesions in both tracers were calculated.

RESULTS: Of the 286 lesions identified, the majority 140 (49%) were lymph node metastases, 118 (41.2%) were bone metastases and 28 lesions (9.8%) were locoregional recurrences of prostate cancer. The median SUVmax value was significantly higher for 18F-PSMA compared with FCH for all 286 lesions (8.26 vs. 4.99, respectively, P < 0.001). There were statistically significant differences in median SUVmean, TL-PSMA/FCH, and PSMA/FCH-TV as per table 2 between the two radiotracers (4.29 vs. 2.92, 1.97 vs. 1.53, and 7.31 vs. 4.37, respectively, P < 0.001). The correlation between SUVmean/SUVmax and PSA level was moderate, both for 18F-PSMA (r = 0.44, P < 0.001; r = 0.44, P < 0.001) and FCH (r = 0.35, P < 0.001; r = 0.41, P < 0.001). TL-PSMA/FCH demonstrated statistically significant positive correlations with both PSA level and PSA velocity for both 18F-PSMA (r = 0.56, P < 0.001; r = 0.57, P < 0.001) and FCH (r = 0.49, P < 0.001; r = 0.51, P < 0.001). While patients who received hormone therapy showed higher median SUVmax values for both radiotracers compared with those who did not, the difference was statistically significant only for 18F-PSMA (P < 0.05).

CONCLUSION: Our analysis using both radiomic features and quantitative biomarkers demonstrated the improved performance of 18F-PSMA-1007 compared with FCH in identifying metastatic lesions in prostate cancer patients with BCR.

PMID:38832429 | DOI:10.1097/MNM.0000000000001867