Tag: nevin manimala

Int J Cardiovasc Imaging. 2023 Sep 21. doi: 10.1007/s10554-023-02949-0. Online ahead of print.

ABSTRACT

Advances in image reconstruction using either single or multimodality imaging data provide increasingly accurate three-dimensional (3D) patient’s arterial models for shear stress evaluation using computational fluid dynamics (CFD). We aim to evaluate the impacts on endothelial shear stress (ESS) derived from a simple image reconstruction using 3D-quantitative coronary angiography (3D-QCA) versus a multimodality reconstruction method using optical coherence tomography (OCT) in patients’ vessels treated with bioresorbable scaffolds. Seven vessels at baseline and five-year follow-up of seven patients from a previous CFD investigation were retrospectively selected for a head-to-head comparison of angiography-derived versus OCT-derived ESS. 3D-QCA significantly underestimated the minimum stent area [MSA] (-2.38mm²) and the stent length (-1.46 mm) compared to OCT-fusion method reconstructions. After carefully co-registering the region of interest for all cases with a sophisticated statistical method, the difference in MSA measurements as well as the inability of angiography to visualise the strut footprint in the lumen surface have translated to higher angiography-derived ESS than OCT-derived ESS (1.76 Pa or 1.52 times for the overlapping segment). The difference in ESS widened with a more restricted region of interest (1.97 Pa or 1.63 times within the scaffold segment). Angiography and OCT offer two distinctive methods of ESS calculation. Angiography-derived ESS tends to overestimate the ESS compared to OCT-derived ESS. Further investigations into ESS analysis resolution play a vital role in adopting OCT-derived ESS.

PMID:37733283 | DOI:10.1007/s10554-023-02949-0

Eur J Clin Pharmacol. 2023 Sep 21. doi: 10.1007/s00228-023-03569-2. Online ahead of print.

ABSTRACT

PURPOSE: The goal of the study was to examine clozapine (CLZ) and norclozapine (NCLZ) therapeutic drug monitoring (TDM) data and associated sources of pharmacokinetic variability, particularly the impact of valproic acid (VPA) use.

METHODS: This study included 126 patients with psychiatric disorders on mono- or co-therapy with CLZ. Patients’ data during routine TDM were collected retrospectively from clinical records. The descriptive and statistical analysis was computed using IBM SPSS Statistics software (version 22, NY, USA). Multiple linear regression, based on the last observations, was used to assess correlation between demographic characteristics, life habits and co-therapy with dose-corrected serum levels (C/D) of CLZ and NCLZ, as well as CLZ/NCLZ.

RESULTS: A total of 295 CLZ concentrations were measured in 126 patients, with a mean of 275.5 ± 174.4 µg/L, while 124 NCLZ concentrations were determined in 74 patients, with a mean of 194.6 ± 149.8 µg/L. A statistically significant effect on ln-transformed CLZ C/D was confirmed for sex and smoking, whereas sex, smoking and VPA therapy were associated with ln-transformed NCLZ C/D. According to the final models, lower values of NCLZ C/D for about 45.9% can be expected in patients receiving VPA. Concomitant use of VPA was the only factor detected to contribute in CLZ/NCLZ variability.

CONCLUSION: The results of this study may help clinicians interpret TDM data and optimize CLZ dosing regimens, especially in patients concomitantly treated with VPA. Our results show that VPA primarily decreases NCLZ levels, while alteration of the parent drug is not statistically significant.

PMID:37733278 | DOI:10.1007/s00228-023-03569-2

Euro Surveill. 2023 Sep;28(38). doi: 10.2807/1560-7917.ES.2023.28.38.2200938.

ABSTRACT

BackgroundThe sensitivity and specificity of selected antigen detection rapid diagnostic tests (AG-RDTs) for SARS-CoV-2 were determined in the unvaccinated population when the Delta variant was circulating. Viral loads, dynamics, symptoms and tissue tropism differ between Omicron and Delta.AimWe aimed to compare AG-RDT sensitivity and specificity in selected subgroups during Omicron vs Delta circulation.MethodsWe retrospectively paired AG-RDT results with PCRs registered in Czechia’s Information System for Infectious Diseases from 1 to 25 December 2021 (Delta, n = 20,121) and 20 January to 24 February 2022 (Omicron, n = 47,104).ResultsWhen confirmatory PCR was conducted on the same day as AG-RDT as a proxy for antigen testing close to peak viral load, the average sensitivity for Delta was 80.4% and for Omicron 81.4% (p < 0.05). Sensitivity in vaccinated individuals was lower for Omicron (OR = 0.94; 95% confidence interval (CI): 0.87-1.03), particularly in reinfections (OR = 0.83; 95% CI: 0.75-0.92). Saliva AG-RDT sensitivity was below average for both Delta (74.4%) and Omicron (78.4%). Tests on the European Union Category A list had higher sensitivity than tests in Category B. The highest sensitivity for Omicron (88.5%) was recorded for patients with loss of smell or taste, however, these symptoms were almost 10-fold less common than for Delta. The sensitivity of AG-RDTs performed on initially asymptomatic individuals done 1, 2 or 3 days before a positive PCR test was consistently lower for Omicron compared with Delta.ConclusionSensitivity for Omicron was lower in subgroups that may become more common if SARS-CoV-2 becomes an endemic virus.

PMID:37733239 | DOI:10.2807/1560-7917.ES.2023.28.38.2200938

Ir J Med Sci. 2023 Sep 21. doi: 10.1007/s11845-023-03526-z. Online ahead of print.

ABSTRACT

BACKGROUND: The major changes in the timing of meals during Ramadan may be challenging for hypothyroid patients on levothyroxine. We aimed to study the effect of Ramadan fasting on thyroid functions in hypothyroid patients taking levothyroxine.

METHODS: We did a comprehensive search of 8 databases for Randomized controlled studies (RCTs) and observational studies investigating the effect of Ramadan fasting on thyroid functions in hypothyroid individuals taking levothyroxine. Relevant data was extracted and analyzed. Mean difference (MD) and standard deviation (SD) were used to evaluate the continuous data. Risk ratios (RR) with a 95% confidence interval were used for outcomes constituting dichotomous data. National Institutes of Health (NIH) tools were used to assess the risk of bias.

RESULTS: Fourteen studies met our inclusion criteria, 3 RCTs, and 11 observational studies, all designed as pre-post studies. Ramadan fasting was associated with a statistically significant increase in TSH in patients who were euthyroid before Ramadan (MD = -0.76 [95% CI; -1.27, -0.25]). However, free thyroxine (FT4) was found to be stable (MD = 0.01, [95% CI; -0.03, 0.06]). All timing points were associated with a significant increase in TSH levels after Ramadan, pre-iftar (MD = -0.69 [95% CI; -1.03, -0.36]), post-iftar (MD = -0.76 [95% CI; -1.12, -0.39]), and pre-suhoor (MD = -1.19 [95% CI; -2.18, -0.19]).

CONCLUSION: TSH increases significantly after Ramadan. No timing point has superiority in maintaining thyroid control. However, choosing the timing should be individualized according to the patient’s preference to guarantee the most possible compliance.

PMID:37733226 | DOI:10.1007/s11845-023-03526-z

Jpn J Radiol. 2023 Sep 21. doi: 10.1007/s11604-023-01486-z. Online ahead of print.

ABSTRACT

The effectiveness and precision of disease diagnosis and treatment have increased, thanks to developments in clinical imaging over the past few decades. Science is developing and progressing steadily in imaging modalities, and effective outcomes are starting to show up as a result of the shorter scanning periods needed as well as the higher-resolution images generated. The choice of one clinical device over another is influenced by technical disparities among the equipment, such as detection medium, shorter scan time, patient comfort, cost-effectiveness, accessibility, greater sensitivity and specificity, and spatial resolution. Lately, computational algorithms, artificial intelligence (AI), in particular, have been incorporated with diagnostic and treatment techniques, including imaging systems. AI is a discipline comprised of multiple computational and mathematical models. Its applications aided in manipulating sophisticated data in imaging processes and increased imaging tests’ accuracy and precision during diagnosis. Computed tomography (CT), positron emission tomography (PET), and Single Photon Emission Computed Tomography (SPECT) along with their corresponding radiation detectors have been reviewed in this study. This review will provide an in-depth explanation of the above-mentioned imaging modalities as well as the radiation detectors that are their essential components. From the early development of these medical instruments till now, various modifications and improvements have been done and more is yet to be established for better performance which calls for a necessity to capture the available information and record the gaps to be filled for better future advances.

PMID:37733205 | DOI:10.1007/s11604-023-01486-z

Disabil Rehabil. 2023 Sep 21:1-9. doi: 10.1080/09638288.2023.2259311. Online ahead of print.

ABSTRACT

Purpose: To understand the circumstances, causes and consequences of falls experienced by individuals with subacute SCI, and to explore their perspectives on how falls/fall risk impacted their transition to community living.Materials and methods: Sixty adults with subacute SCI participated. A sequential explanatory mixed methods design was adopted. In Phase I, falls were monitored for six months post-inpatient rehabilitation discharge through a survey. In Phase II, a qualitative focus group (n = 5) was held to discuss participants’ perspectives on Phase I results and falls/fall risk. Descriptive statistics and thematic analysis were used to analyze Phase I and II data, respectively.Results: Falls commonly occurred in the daytime, at home and about half resulted in minor injury. Three themes reflecting participants’ perspectives were identified in Phase II. 1) Lack of preparedness to manage fall risk upon returning home from inpatient rehabilitation. 2) Adjusting to increased fall risk following discharge from inpatient rehabilitation. 3) Psychological impact of the transition to living at home with an increased fall risk.Conclusions: The findings highlight the need for fall prevention initiatives during subacute SCI, when individuals are learning to manage their increased fall risk.

PMID:37732508 | DOI:10.1080/09638288.2023.2259311

J Integr Bioinform. 2023 Sep 21. doi: 10.1515/jib-2022-0029. Online ahead of print.

ABSTRACT

Many important aspects of biological knowledge at the molecular level can be represented by pathways. Through their analysis, we gain mechanistic insights and interpret lists of interesting genes from experiments (usually omics and functional genomic experiments). As a result, pathways play a central role in the development of bioinformatics methods and tools for computing predictions from known molecular-level mechanisms. Qualitative as well as quantitative knowledge about pathways can be effectively represented through biochemical networks linking the biochemical reactions and the compounds (e.g., proteins) occurring in the considered pathways. So, repositories providing biochemical networks for known pathways play a central role in bioinformatics and in systems biology. Here we focus on Reactome, a free, comprehensive, and widely used repository for biochemical networks and pathways. In this paper, we: (1) introduce a tool StARGate-X (STatistical Analysis of the Reactome multi-GrAph Through nEtworkX) to carry out an automated analysis of the connectivity properties of Reactome biochemical reaction network and of its biological hierarchy (i.e., cell compartments, namely, the closed parts within the cytosol, usually surrounded by a membrane); the code is freely available at https://github.com/marinoandrea/stargate-x; (2) show the effectiveness of our tool by providing an analysis of the Reactome network, in terms of centrality measures, with respect to in- and out-degree. As an example of usage of StARGate-X, we provide a detailed automated analysis of the Reactome network, in terms of centrality measures. We focus both on the subgraphs induced by single compartments and on the graph whose nodes are the strongly connected components. To the best of our knowledge, this is the first freely available tool that enables automatic analysis of the large biochemical network within Reactome through easy-to-use APIs (Application Programming Interfaces).

PMID:37732505 | DOI:10.1515/jib-2022-0029

J Pharm Pract. 2023 Sep 21:8971900231202647. doi: 10.1177/08971900231202647. Online ahead of print.

ABSTRACT

Background: Pharmacy board certification provides pharmacists with formal recognition of their careers and their involvement in direct and comprehensive patient care. Credentialing as a board-certified pharmacist demonstrates that the pharmacist has specialized expertise and is able to provide advanced level patient care in a specific pharmacy practice specialty. There is currently not a community pharmacy board certification available in the United States. With the expanding role and clinical expectations of community pharmacists nationwide, perspectives regarding the utility of a community pharmacy specialty board certification are necessary. Methods: A cross-sectional survey with demographic and perception questions (5-point Likert scale) was distributed electronically via Qualtrics. A random sample of pharmacists registered in Rhode Island, Ohio, and Nebraska were selected and surveyed. Results: 53 survey responses were collected. There was a statistically significant difference in board certification history (P = .001) and history of post-graduate training (P < .001) between community pharmacists and non-community pharmacists. Community pharmacists were more likely to simultaneously see community pharmacists as general practitioners (P = .030) and as pharmacy practice specialists (P = .001). Non-community pharmacists were more likely to be familiar with current maintenance requirements for pharmacy board certifications (P < .001) and to feel that a board certification is an appropriate indicator of experience in a pharmacy specialty area (P = .016). Conclusion: Views regarding community pharmacy and board certification differed between community and non-community pharmacists. There was not a statistically significant difference in the perceived value of community pharmacy board certification between community and non-community pharmacist.

PMID:37732497 | DOI:10.1177/08971900231202647

Hypertension. 2023 Sep 21. doi: 10.1161/HYPERTENSIONAHA.123.19941. Online ahead of print.

ABSTRACT

There has been considerable progress in the prevention and treatment of cardiovascular disease, reducing the population burden of cardiovascular morbidity and mortality. Recently, some randomized trials, including the SPRINT (Systolic Blood Pressure Intervention Trial), have suggested that improvements in cardiovascular risk factors may also slow cognitive decline and reduce the eventual development of dementia. Unfortunately, the randomized trial template that has been used repeatedly to successfully demonstrate reductions in major adverse cardiac events faces several design and analytic obstacles when applied in the context of cognitive decline and dementia. Here, we review these obstacles, motivated by SPRINT and the context of selecting an appropriate cognitive end point for future preventive randomized trials. A few options are available, spanning neuropsychological test scores or composites reflecting specific domains of cognitive function, adjudicated cognitive impairment, or potentially physiological biomarkers. This choice entails considerations around statistical power, modes of ascertainment, the clinical relevance of treatment effects, a myriad of statistical issues (interval censoring, missing data, the competing risk of death, practice effects, etc), as well as ethical considerations around equipoise. Collectively, these considerations indicate that trials aiming to mitigate the cardiovascular contribution to cognitive decline and dementia will generally need to be large, inclusive of a wide age range of older adults, and with multiple years of follow-up.

PMID:37732473 | DOI:10.1161/HYPERTENSIONAHA.123.19941

Womens Health (Lond). 2023 Jan-Dec;19:17455057231199038. doi: 10.1177/17455057231199038.

ABSTRACT

BACKGROUND: Since 2019, the coronavirus disease-19 pandemic and its consequences from restrictions to risks have impacted our lives in all aspects. Pregnant women are especially vulnerable to the changes that were implemented as a result of the shift in healthcare priorities and the medical and social implications of the lockdown.

OBJECTIVES: This study aimed to assess the experience of giving birth during the pandemic, how this is affected by acquiring coronavirus disease-19 infection, and its effect on postnatal mood.

DESIGN: A cross-sectional study was conducted which involved 490 women who gave birth during the pandemic across the Hashemite Kingdom of Jordan.

METHODS: An electronic questionnaire was distributed among women experiencing childbirth during this period in Jordan by advertising it on social media platforms targeting pregnant women and mothers. The sample size was statistically determined to be representative of the population. Statistical analysis was performed using Statistical Package for the Social Sciences for Windows v.27.

RESULTS: The study demonstrated that getting infected with the virus throughout the pregnancy did not affect the childbirth experience with respect to the parameters measured, but other factors during the pandemic such as the type of hospital and mode of delivery did. Positive interaction with staff in the delivery suite was a major determinant of a positive birth experience. Women associated low mood post-delivery with giving birth in pandemic circumstances, and it affected first-time mothers more than multiparous women.

CONCLUSION: Although the acquisition of coronavirus disease-19 infection did not have a significant impact on women’s childbirth experience, several pandemic-related factors did. Given the importance of a woman’s perception and evaluation of events surrounding her birth experience in determining her postnatal physical and psychological well-being, having to give birth during the pandemic circumstances, especially for first-time mothers, can have potentially detrimental consequences that may affect her health and reproductive choices in the future. The results of this study offer a better understanding of the effect of pandemic and lockdown circumstances on the perceived experience of mothers during childbirth and postnatally and factors that should be taken into consideration when planning healthcare provision to this population in future similar conditions.

PMID:37732465 | DOI:10.1177/17455057231199038