Tag: nevin manimala

Sci Rep. 2023 Nov 8;13(1):19371. doi: 10.1038/s41598-023-46295-6.

ABSTRACT

Gene regulation plays an important role in understanding the mechanisms of human biology and diseases. However, inferring causal relationships between all genes is challenging due to the large number of genes in the transcriptome. Here, we present SIGNET (Statistical Inference on Gene Regulatory Networks), a flexible software package that reveals networks of causal regulation between genes built upon large-scale transcriptomic and genotypic data at the population level. Like Mendelian randomization, SIGNET uses genotypic variants as natural instrumental variables to establish such causal relationships but constructs a transcriptome-wide gene regulatory network with high confidence. SIGNET makes such a computationally heavy task feasible by deploying a well-designed statistical algorithm over a parallel computing environment. It also provides a user-friendly interface allowing for parameter tuning, efficient parallel computing scheduling, interactive network visualization, and confirmatory results retrieval. The Open source SIGNET software is freely available ( https://www.zstats.org/signet/ ).

PMID:37938594 | DOI:10.1038/s41598-023-46295-6

Sci Rep. 2023 Nov 8;13(1):19390. doi: 10.1038/s41598-023-46183-z.

ABSTRACT

Body surface area (BSA) is the most commonly used metric for body size indexation of echocardiographic measures, but its use in patients who are underweight or obese is questioned (body mass index (BMI) < 18.5 kg/m² or ≥ 30 kg/m², respectively). We aim to use survival analysis to identify an optimal body size indexation metric for echocardiographic measures that would be a better predictor of survival than BSA regardless of BMI. Adult patients with no prior valve replacement were selected from the National Echocardiography Database Australia. Survival analysis was performed for echocardiographic measures both unindexed and indexed to different body size metrics, with 5-year cardiovascular mortality as the primary endpoint. Indexation of echocardiographic measures (left ventricular end-diastolic diameter [n = 230,109] and mass [n = 224,244], left atrial volume [n = 150,540], aortic sinus diameter [n = 90,805], right atrial area [n = 59,516]) by BSA had better prognostic performance vs unindexed measures (underweight: C-statistic 0.655 vs 0.647; normal weight/overweight: average C-statistic 0.666 vs 0.625; obese: C-statistic 0.627 vs 0.613). Indexation by other body size metrics (lean body mass, height, and/or weight raised to different powers) did not improve prognostic performance versus BSA by a clinically relevant magnitude (average C-statistic increase ≤ 0.02), with smaller differences in other BMI subgroups. Indexing measures of cardiac and aortic size by BSA improves prognostic performance regardless of BMI, and no other body size metric has a clinically meaningful better performance.

PMID:37938592 | DOI:10.1038/s41598-023-46183-z

CJEM. 2023 Nov 8. doi: 10.1007/s43678-023-00604-0. Online ahead of print.

ABSTRACT

BACKGROUND: Little evidence exists studying the benefits of pre-hospital trauma team activation. Our study measured the impact of pre-hospital trauma team activation on 24-h survival. Our secondary objectives assessed the effects of pre-hospital trauma team activation on time to emergency procedure, computed tomography, blood transfusion, and critical administration threshold, as well as emergency department length of stay.

METHODS: We conducted a 40-month health records review on all trauma team activations at The Ottawa Hospital, a Level 1 Trauma Center. Outcomes were compared between pre-hospital and in-hospital trauma team activations. We used logistic and linear regression models to assess outcomes, while controlling for injury severity score, age, systolic blood pressure, and anti-coagulation use. A P value < 0.05 was considered statistically significant. A sensitivity analysis was also used to validate the primary outcome results.

RESULTS: Of the 1013 trauma team activations occurring during the study period, 762 patients were included. The mean age (41.3 vs. 43.8) and percentage of males (79.4% vs. 77.5%) for pre-hospital activations were similar to their counterparts. Pre-hospital activations did not have a statistically significant effect on 24-h mortality (14.4% vs. 4.5%; P = 0.30). However, pre-hospital activations did demonstrate a statistically significant reduction in time (minutes) to emergency procedure (18.0 vs. 27.0; P < 0.001), computed tomography (37.0 vs 42.0; P = 0.009), and blood transfusion (14.0 vs. 28.0; P < 0.001), as well as emergency department length of stay (101.0 vs. 171.0; P < 0.001).

CONCLUSION: When controlling for key covariates, pre-hospital trauma team activation did not have a significant effect on 24-h mortality, but did result in a significant reduction in time to emergency procedure, computed tomography, and blood transfusion, as well as emergency department length of stay. Our study demonstrates that pre-hospital trauma team activation can expedite patient intervention and disposition.

PMID:37938515 | DOI:10.1007/s43678-023-00604-0

Breast Cancer Res Treat. 2023 Nov 8. doi: 10.1007/s10549-023-07159-9. Online ahead of print.

ABSTRACT

PURPOSE: To assess whether erythropoiesis-stimulating agents (ESA) administration impacts the outcomes of patients with HER2-positive early breast cancer (EBC).

METHODS: ALTTO (NCT00490139) patients were categorized by ESA use during adjuvant anti-HER2 treatment. Disease-free-survival (DFS), overall survival (OS), and time-to-distant recurrence (TTDR) were analyzed by ESA administration, with subgroup analyses according to prognostic factors. Log-rank tests and Cox modeling were performed. Adverse events (AEs) of ESA-interest were compared.

RESULTS: Among 8381 patients recruited in ALTTO, 123 (1.5%) received ESA concomitantly with study treatment. The median age of patients receiving ESA was 54 years, 39.0% premenopausal, most had tumor size > 2 cm (56.9%), node-positive (58.5%), and positive estrogen receptor expression (61.8%). Median follow-up was shorter in the ESA group [6.1 years (IQR 5.3-7.0) vs. 6.9 years (6.0-7.1); p < 0.001]. There was no DFS difference by ESA administration (log-rank p = 0.70), with 3- and 7-year DFS of 89.2% (95% CI 81.8-93.8%) and 81.6% (71.4-88.5%) in ESA group vs. 88.3% (87.6-89.0%) and 80.0% (79.1-80.9%) in No-ESA group. In subgroup analyses, the interaction of ESA administration with menopausal status was statistically significant (unadjusted p = 0.024; stratified p = 0.033), favoring premenopausal women receiving ESA. We observed no significant association of ESA administration with OS (log-rank p = 0.57; 7-year OS in ESA 88.6% vs. 90.0% in non-ESA) or TTDR. ESA-interest AEs were experienced by eight (6.5%) patients receiving ESA and 417 (5.1%) in the No-ESA group (p = 0.41).

CONCLUSION: ESA administration to patients receiving adjuvant anti-HER2 treatment for HER2-positive EBC was safe and not associated with a negative impact on survival outcomes.

PMID:37938495 | DOI:10.1007/s10549-023-07159-9

Environ Sci Pollut Res Int. 2023 Nov 8. doi: 10.1007/s11356-023-30780-6. Online ahead of print.

ABSTRACT

The Sistan region in Southeastern Iran is one of the world’s most sensitive areas when it comes to sandstorms and wind erosion. One of the most influential factors in interpreting sandstorms is sand drift potential (DP), which is directly related to wind speed. Accurately, monitoring this phenomenon is still being determined, considering various temporal scales. Therefore, the main aim of this research is to analyze the trend of DP on monthly and annual scales. Our results showed that monthly variations of DP reached the highest and lowest values in July (609 VU) and January (47 VU), respectively. Blowing sand predominantly moved southeast, and the directional index fluctuated from 0.88 to 0.94. The annual DP was measured equal to 2700 VU, signifying a relatively high value when compared to other arid regions worldwide. The trend analysis results obtained from the Mann-Kendall test revealed both positive trends during the period 1987-2001 and negative ones from 2002 to 2016). However, the positive trend was found statistically insignificant. Furthermore, Sen’s slope test results demonstrated that a negative trend could be observed with a steeper slope during July, September, and August, while a positive trend could be observed with a steeper pitch during November, December, and June. We recommend that land managers and stakeholders involved in controlling blowing sand using biological and physical methods should consider these trends in the Sistan region. Implementing nature-based solutions or control strategies should focus on these temporal sequences.

PMID:37938486 | DOI:10.1007/s11356-023-30780-6

Int J Implant Dent. 2023 Nov 8;9(1):43. doi: 10.1186/s40729-023-00511-0.

ABSTRACT

PURPOSE: Implant-supported immediately loaded fixed full-arch rehabilitation via All-on-four treatment yields good long-term results for both the maxilla and the mandible. However, the risk factors affecting long-term implant survival are unknown, and the long-term prognosis of All-on-four concept procedures in Japanese individuals has not been elucidated. We aimed to determine the cumulative implant survival rate after 3-17-year follow-up and identify the associated risk factors.

METHODS: We analysed 561 cases (307 maxillae, 254 mandibles) with 2364 implants (1324 maxillae, 1040 mandibles) that received All-on-four treatment. We investigated the cumulative implant- and patient-level survival rates and various risk factors for implant failure. Statistical analysis was performed using the log-rank test for differences in Kaplan-Meier curves, univariate analysis using the Chi-square test, and multivariate analysis for risk factors affecting the survival rate.

RESULTS: The cumulative survival rate was 94.4% by patient level and 97.4% by implant level for the maxilla, and 96.7% by patient level and 98.9% by implant for the mandible, with up to 17 years of follow-up. The maxillary survival rate at the implant level was significantly lower (p < 0.05). Furthermore, the maxillary survival rate within 24 months was significantly lower at the implant level (p < 0.01). Multivariate analysis revealed that the maxilla was the most significant risk factor (p < 0.01).

CONCLUSIONS: All-on-four treatment yielded high long-term survival rates in Japanese patients. However, the maxilla showed a significantly lower cumulative survival rate than the mandible, while early failure was significantly higher. Furthermore, the maxilla was a significant risk factor influencing the survival rate.

PMID:37938479 | DOI:10.1186/s40729-023-00511-0

Sports Med Open. 2023 Nov 8;9(1):104. doi: 10.1186/s40798-023-00653-w.

ABSTRACT

BACKGROUND: Although several studies have shown that the Coronavirus Disease 2019 (COVID-19) lockdown has had negative impacts on mental health and eating behaviors among the general population and athletes, few studies have examined the long-term effects on elite and sub-elite athletes. The present study aimed to investigate the long-term impact of COVID-19 lockdown on mental health and eating behaviors in elite versus sub-elite athletes two years into the pandemic. A cross-sectional comparative study was conducted between March and April 2022, involving athletes from 14 countries, using a convenient non-probabilistic and snowball sampling method. A total of 1420 athletes (24.5 ± 7.9 years old, 569 elites, 35% women, and 851 sub-elites, 45% women) completed an online survey-based questionnaire. The questionnaire included a sociodemographic survey, information about the COVID-19 pandemic, the Depression, Anxiety and Stress Scale-21 Items (DASS-21) for mental health assessment, and the Rapid Eating Assessment for Participants (REAP-S) for assessing eating behavior.

RESULTS: The results showed that compared to sub-elite athletes, elite athletes had lower scores on the DASS-21 (p = .001) and its subscales of depression (p = .003), anxiety (p = .007), and stress (p < .001), as well as a lower REAP-S score indicating lower diet quality (p = .013).

CONCLUSION: In conclusion, two years into the pandemic, elite athletes were likelier to have better mental health profiles than sub-elite athletes but surprisingly had lower diet quality.

PMID:37938473 | DOI:10.1186/s40798-023-00653-w

Matern Child Health J. 2023 Nov 8. doi: 10.1007/s10995-023-03814-1. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of the study was to identify factors associated with a risk of suspected developmental delay (SDD) in high-risk children in Thailand.

METHODS: We used data on children enrolled for developmental delay (DD) screening across Thailand collected by the Rajanagarindra Institute of Child Development, Department of Mental Health, Ministry of Public Health, Thailand. Children who were under 5 years of age with a birth weight of fewer than 2500 g and/or birth asphyxia in Thailand with high risk of DD were assessed using the Developmental Assessment for Intervention Manual (DAIM) between August 2013 and November 2019 (N = 14,314).

RESULTS: The high-risk children who had a gestational age at birth of < 37 weeks (adjusted odds ratio = 1.54; 95% confidence interval = 1.39-1.70) and/or had a birth weight < 2500 g (1.22; 1.02-1.45), or had mothers who were not government officers (1.46; 1.11-1.93), had a low education level (1.36; 1.19-1.55), had a poor nutritional status (1.34; 1.09-1.65), and/or who were living in a high-altitude area (1.59; 1.32-1.91) were at a higher risk of SDD.

CONCLUSIONS FOR PRACTICE: Children with a low birth weight and/or asphyxia during birth had a high risk of DD. SDD monitoring of children by community health workers and/or by developing outreach strategies, especially in underserved regions, should be considered. In addition, developing policies and guidelines, and intervention for high-risk children ought to be conducted to reduce the subsequent problems caused by the late detection of DD.

PMID:37938440 | DOI:10.1007/s10995-023-03814-1

J Cancer Surviv. 2023 Nov 8. doi: 10.1007/s11764-023-01483-1. Online ahead of print.

ABSTRACT

PURPOSE: The impact of changes in therapy for childhood acute lymphoblastic leukemia (ALL) and non-Hodgkin lymphoma (NHL) on the prevalence of physical performance limitations and participation restrictions among survivors is unknown. We aimed to describe the prevalence of reduced function among ALL and NHL survivors by treatment era.

METHODS: Participants included survivors of childhood ALL and NHL, and a cohort of their siblings, participating in the Childhood Cancer Survivor Study (CCSS). Physical function was measured using questionnaire. The prevalence of reduced function was compared to siblings using generalized estimating equations, overall and stratified by treatment decade. Associations between organ system-specific chronic conditions (CTCAE v4.03) and function were also evaluated.

RESULTS: Among 6511 survivors (mean age 25.9 years (standard deviation 6.5)) and 4127 siblings, risk of performance limitations (15.2% vs. 12.5%, prevalence ratio [PR] = 1.5, 95%CI = 1.3-1.6), restrictions in personal care (2.0% vs. 0.6%, PR = 3.1, 95% CI = 2.0-4.8), routine activities (5.5% vs. 1.6%, PR = 3.6, 95% CI = 2.7-4.8), and work/school attendance (8.8% vs. 2.1%, PR = 4.5, 95% CI = 3.6-5.7) was increased in survivors vs. siblings. The prevalence of survivors reporting reduced function did not decrease between the 1970s and 1990s. The presence of neurological and cardiovascular conditions was associated with reduced function regardless of treatment decade.

CONCLUSIONS: Despite changes in therapy, the prevalence of poor physical function remained constant between the 1970s and 1990s. The CCSS clinical trial registration number is NCT01120353 (registered May 6, 2010).

IMPLICATIONS FOR CANCER SURVIVORS: Our findings support screening for reduced physical function so that early interventions to improve physical performance and mitigate chronic disease can be initiated.

PMID:37938431 | DOI:10.1007/s11764-023-01483-1

Spine (Phila Pa 1976). 2023 Nov 8. doi: 10.1097/BRS.0000000000004857. Online ahead of print.

ABSTRACT

STUDY DESIGN: retrospective cohort.

OBJECTIVE: To report normative measurements of L1-S1 lumbar neuroforamina on plain film radiography (PFR), computed tomography (CT), and magnetic resonance imaging (MRI), accounting for patient sex and ethnicity.

SUMMARY OF BACKGROUND DATA: Quantitative criteria for diagnosis of neuroforaminal stenosis (NFS) remains unknown. Acquiring a thorough understanding of normative foraminal dimensions is a key step in formulating objective parameters for NFS.

METHODS: We measured 988 images from 494 patients between 18 and 35 years-old without spinal pathology who received PFR, CT, or MRI within one year of each other. Neuroforaminal measurements were defined as the height, area, and sagittal and axial widths. Statistical analyses were performed to assess relationships among PFR-, CT-, and MRI-derived neuroforaminal measurements as well as the influence of patient sex and ethnicity.

RESULTS: 330 PFR, 377 CT, and 281 MRI were measured. Of these, 213 PFR and CT, 117 PFR and MRI, and 164 MRI and CT intrapatient images were compared. Statistically significant differences were observed among PFR, CT, and MRI measurements across all levels L1-S1. PFR measurements were larger compared to those derived from CT and MRI. Weak-to-moderate correlations were observed between PFR and CT, PFR and MRI, and CT and MRI, with the magnitude of correlation decreasing caudally from L1-S1. Variations in neuroforaminal anatomy were observed based on sex and ethnicity.

CONCLUSION: This study reports 25,951 measurements of normal L1-S1 neuroforaminal anatomy assessed by PFR, CT, and MRI. The values reported in this study may be used as normative reference measurements of the lumbar neuroforamina. PFR measurements of the neuroforamina are larger compared to those derived from CT and MRI across all levels from L1-S1. There is poor correlation among PFR, CT and MRI when measuring the lumbar neuroforamina. Differences in neuroforaminal anatomy are evident based on patient sex and ethnicity.

PMID:37937514 | DOI:10.1097/BRS.0000000000004857