Tag: nevin manimala

Reumatol Clin (Engl Ed). 2023 Aug-Sep;19(7):363-373. doi: 10.1016/j.reumae.2022.10.003.

ABSTRACT

BACKGROUND AND AIMS: Systemic inflammatory diseases could act as an unfavorable condition in which epicardial adipose tissue (EAT) becomes harmful to cardiovascular health. The objectives were: (a) to quantitatively compare the presence of EAT between patients with systemic inflammatory diseases and controls; (b) to analyze the association between EAT and subclinical atheromatosis in individuals with systemic inflammatory diseases.

METHODS: Studies that have quantified EAT in a population with systemic inflammatory diseases compared to a control group, or that describe the association between EAT and the presence of subclinical atheromatosis in patients with systemic inflammatory diseases were included. A quantitative analysis was performed for the first objective. This systematic review was performed according to PRISMA guidelines.

RESULTS: Twenty-one studies including 1448 patients with systemic inflammatory diseases, were considered eligible for this study. Patients with systemic inflammatory disease have a higher volume (MD: 10.4cm³ [1.8-19.1]; p<0.01), higher thickness (MD: 1.0mm [0.8-1.2]; p<0.01), and a statistically non-significant higher area (MD: 3.1cm² [1.0-5.2]; p=0.46) of EAT compared to the control group. Most studies reported a significant association between EAT and subclinical atheromatosis in patients with different systemic inflammatory diseases.

CONCLUSION: This study demonstrated that EAT is increased in patients with systemic inflammatory diseases compared with healthy controls, and that EAT measurement is closely correlated with subclinical atherosclerosis in these patients. The causality of this association should be tested in prospective studies.

PMID:37661114 | DOI:10.1016/j.reumae.2022.10.003

Reumatol Clin (Engl Ed). 2023 Aug-Sep;19(7):358-362. doi: 10.1016/j.reumae.2022.12.006.

ABSTRACT

BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune disease in which the immune system abnormally reacts against cells and tissues leading to inflammation. Epigenetic alterations, including DNA methylation and histone modification, have critical effects on autoimmune disease and SLE pathogenesis via dysregulation of critical genes.

AIMS: The purpose of this study was to evaluate the epigenetic-related gene expression of DNA methyltransferase (DNMT) and histone deacetylase 1 (HDAC1) in Iranian patients with SLE.

METHODS: This matched case-control study included 16 people with SLE and 16 healthy people who were referred to the Rafsanjani rheumatology clinic, in southeast Iran. The expression of DNMT and HDAC1 genes was measured through a real-time PCR assay of blood samples.

RESULTS: DNMT gene expression did not differ significantly between SLE and healthy groups (P=0.21). In contrast, HDAC1 gene expression was enhanced in the SLE group, but this enhancement failed to reach statistical significance (P=0.94).

CONCLUSION: The results of this study suggest that overexpression of HDAC1 could serve as a diagnostic for SLE disease. Additional studies with larger sample sizes are required to confirm our findings. Evaluation of other genes related to SLE disease is essential and may help to make an accurate diagnosis of the disease.

PMID:37661113 | DOI:10.1016/j.reumae.2022.12.006

J Immunother Cancer. 2023 Sep;11(9):e007552. doi: 10.1136/jitc-2023-007552.

ABSTRACT

BACKGROUND: ONCOS-102, an oncolytic adenovirus expressing granulocyte-macrophage colony-stimulating factor, can alter the tumor microenvironment to an immunostimulatory state. Combining ONCOS-102 with standard-of-care chemotherapy for malignant pleural mesothelioma (MPM) may improve treatment outcomes.

METHODS: In this open-label, randomized study, patients with unresectable MPM received intratumoral ONCOS-102 (3×10¹¹ virus particles on days 1, 4, 8, 36, 78, and 120) and pemetrexed plus cisplatin/carboplatin (from day 22), or pemetrexed plus cisplatin/carboplatin alone. The primary endpoint was safety. Overall survival (OS), progression-free survival, objective response rate, and tumor immunologic activation (baseline and day 36 biopsies) were also assessed.

RESULTS: In total, 31 patients (safety lead-in: n=6, randomized: n=25) were enrolled. Anemia (15.0% and 27.3%) and neutropenia (40.0% and 45.5%) were the most frequent grade ≥3 adverse events (AEs) in the ONCOS-102 (n=20) and chemotherapy-alone (n=11) cohorts. No patients discontinued ONCOS-102 due to AEs. No statistically significant difference in efficacy endpoints was observed. There was a numerical improvement in OS (30-month OS rate 34.1% vs 0; median OS 20.3 vs 13.5 months) with ONCOS-102 versus chemotherapy alone in chemotherapy-naïve patients (n=17). By day 36, ONCOS-102 was associated with increased T-cell infiltration and immune-related gene expression that was not observed in the control cohort. Substantial immune activation in the tumor microenvironment was associated with survival at month 18 in the ONCOS-102 cohort.

CONCLUSIONS: ONCOS-102 plus pemetrexed and cisplatin/carboplatin was well tolerated by patients with MPM. In injected tumors, ONCOS-102 promoted a proinflammatory environment, including T-cell infiltration, which showed association with survival at month 18.

PMID:37661097 | DOI:10.1136/jitc-2023-007552

J Acad Nutr Diet. 2023 Sep 1:S2212-2672(23)01494-6. doi: 10.1016/j.jand.2023.08.131. Online ahead of print.

ABSTRACT

BACKGROUND: Research on feeding in early childhood has focused primarily on parent-child dyadic interactions, despite parents enacting these practices within the complex dynamic of the family system.

OBJECTIVE: Using a sibling design, this study aimed to assess how parents may adapt their food parenting practices for siblings in response to differences in their eating behaviours.

DESIGN: A cross-sectional online survey was conducted between October and December 2022.

PARTICIPANTS/SETTING: Data were collected from parents (97.5% females) in Australia with two children aged 2 to 5 years (n=336 parents, n=672 children).

MAIN OUTCOME MEASURES: Survey items were completed for each sibling, and included four subscales of the Children’s Eating Behaviour Questionnaire (CEBQ) and seven subscales of the Feeding Practices and Structure Questionnaire-28 (FPSQ-28).

STATISTICAL ANALYSES PERFORMED: Multiple linear regression models examined associations between within-sibling pair differences in child eating behaviours and food parenting practices, adjusting for differences in child body mass index z-score (BMIz), age, gender, and early feeding method.

RESULTS: Within-sibling pair differences in eating behaviours were associated with differences in some food parenting practices. For the fussier sibling, parents reported using more control-based practices, including persuasive feeding, reward for eating, and reward for behaviour, and less of the structure-based practice, family meal settings (ps<0.001). Similar directions of associations were found for persuasive feeding, reward for eating, and family meal settings with siblings who were slower eaters or more satiety responsive (ps<0.007); however, no significant differences in reward for behaviour were observed in relation to sibling differences in these eating behaviours. For the more food responsive sibling, parents reported using more control-based practices, including reward for behaviour and overt restriction (ps<0.002).

CONCLUSIONS: Within families, parents may adapt certain practices in response to differences in their children’s eating behaviours. Interventions promoting responsive feeding should be designed to acknowledge the integral role of siblings in shaping parents’ feeding decisions.

PMID:37661083 | DOI:10.1016/j.jand.2023.08.131

J Affect Disord. 2023 Sep 1:S0165-0327(23)01125-4. doi: 10.1016/j.jad.2023.08.138. Online ahead of print.

ABSTRACT

BACKGROUND: Studies have shown that family function is associated with emotional behavior problems. However, the underlying relationship mechanisms between family function and emotional behavior problems in children and adolescents is not fully understood. Therefore, the purpose of this study is to explore the mediating effect of resilience and the moderating effect of sleep quality using a moderated mediation model.

METHODS: 6363 children and adolescents in grades four to nine were surveyed in some areas of Anhui Province, China. Family function, resilience, sleep quality, and emotional behavior problems were measured through a self-administered questionnaire. All data analysis was by performed by SPSS 23.0.

RESULTS: The results showed that family function was negatively associated with emotional behavior problems (r = -0.307, p < 0.01). Resilience partially mediated the relationship between family function and emotional behavior problems (indirect effect = -0.108, accounted for 38.4 %). Sleep quality moderated the relationship between family function and resilience (β = -0.039, P < 0.001).

CONCLUSION: Resilience and sleep quality respectively played a mediating and moderating effect in the relationship between family function and emotional behavior problems. These findings suggest that we should pay attention to the family function of children and adolescents in time, improve their resilience and sleep quality, so as to effectively reduce the occurrence of emotional behavior problems.

PMID:37661061 | DOI:10.1016/j.jad.2023.08.138

J Foot Ankle Surg. 2023 Sep 1:S1067-2516(23)00218-1. doi: 10.1053/j.jfas.2023.08.013. Online ahead of print.

ABSTRACT

Whether secondary to deformity, traumatic injury, infection, neoplasm, or ischemic disease, the transmetatarsal amputation provides a functional means of limb preservation prior to major proximal amputation. With similar readmission rates following inpatient and outpatient surgery, prevention of an unnecessary admission among vulnerable patients, specifically geriatrics, proves beneficial. This investigation examines differences among geriatric patients admitted and not requiring readmission following outpatient transmetatarsal amputation. An ACS NSQIP database analysis following filtering for CPT 28805, specific for transmetatarsal amputations, was performed among geriatric patients. Patient demographic, medical history, operative characteristics, and social/functional determinants were compared between the no admission and readmission cohorts. The threshold for statistical significance was set at p ≤ 0.05. Overall, a 19% readmission rate was reported among geriatric patients who underwent an outpatient transmetatarsal amputation. No statistically significant difference among patient demographics, past medical history, or surgical presentation was found between cohorts. Geriatric patients that maintained some level of functional dependence were 3.41 times more likely to be readmitted than the non-readmission cohort (p = 0.006). Among geriatric patients undergoing outpatient transmetatarsal amputation, function status should be taken into account prior to surgery. Greater consideration should also be given to patients who do not maintain independence during their activities of daily living. As the population continues to age, recognizing social circumstances associated with the geriatric population proves important in preventing readmission.

PMID:37661019 | DOI:10.1053/j.jfas.2023.08.013

Resuscitation. 2023 Sep 1:109956. doi: 10.1016/j.resuscitation.2023.109956. Online ahead of print.

ABSTRACT

AIM: Frequency and timing of Withdrawal of Life-Sustaining Treatment (WLST) after Out-of-Hospital Cardiac Arrest (OHCA) vary across Intensive Care Units (ICUs) in the United Kingdom (UK) and may be a marker of lower healthcare quality if instituted too frequently or too early. We aimed to describe WLST practice, quantify its variability across UK ICUs, and assess the effect of institutional deviation from average practice on patients’ risk-adjusted hospital mortality.

METHODS: We conducted a retrospective multi-centre cohort study including all adult patients admitted after OHCA to UK ICUs between 2010-2017. We identified patient and ICU characteristics associated with early (within 72h) and late (>72h) WLST and quantified the between-ICU variation. We used the ICU-level observed-to-expected (O/E) ratios of early and late-WLST frequency as separate metrics of institutional deviation from average practice and calculated their association with patients’ hospital mortality.

RESULTS: We included 28438 patients across 204 ICUs. 10775 (37.9%) had WLST and 6397 (59.4%) of them had early-WLST. Both WLST types were strongly associated with patient-level demographics and pre-existing conditions but weakly with ICU-level characteristics. After adjustment, we found unexplained between-ICU variation for both early-WLST (Median Odds Ratio 1.59, 95%CrI 1.49-1.71) and late-WLST (MOR 1.39, 95%CrI 1.31-1.50). Importantly, patients’ hospital mortality was higher in ICUs with higher O/E ratio of early-WLST (OR 1.29, 95%CI 1.21-1.38, p<0.001) or late-WLST (OR 1.39, 95%CI 1.31-1.48, p<0.001).

CONCLUSIONS: Significant variability exists between UK ICUs in WLST frequency and timing. This matters because unexplained higher-than-expected WLST frequency is associated with higher hospital mortality independently of timing, potentially signalling prognostic pessimism and lower healthcare quality.

PMID:37661013 | DOI:10.1016/j.resuscitation.2023.109956

Biol Psychiatry. 2023 Sep 1:S0006-3223(23)01530-5. doi: 10.1016/j.biopsych.2023.08.018. Online ahead of print.

ABSTRACT

BACKGROUND: The 1q21.1 distal and 15q11.2 BP1-BP2 CNVs exhibit regional and global brain differences compared to non-carriers. However, interpreting regional differences is challenging if a global difference drives the regional brain differences. Intra-individual variability measures can be used to test for regional differences beyond global differences in brain structure.

METHODS: Magnetic resonance imaging data were used to obtain regional brain values for 1q21.1 distal deletion (n=30) and duplication (n=27), and 15q11.2 BP1-BP2 deletion (n=170) and duplication (n=243) carriers and matched non-carriers (n=2,350). Regional intra-deviation (RID) scores i.e., the standardized difference between an individual’s regional difference and global difference, were used to test for regional differences that diverge from the global difference.

RESULTS: For the 1q21.1 distal deletion carriers, cortical surface area for regions in the medial visual cortex, posterior cingulate and temporal pole differed less, and regions in the prefrontal and superior temporal cortex differed more than the global difference in cortical surface area. For the 15q11.2 BP1-BP2 deletion carriers, cortical thickness in regions in the medial visual cortex, auditory cortex and temporal pole differed less, and the prefrontal and somatosensory cortex differed more than the global difference in cortical thickness.

CONCLUSION: We find evidence for regional effects beyond differences in global brain measures in 1q21.1 distal and 15q11.2 BP1-BP2 CNVs. The results provide new insight into brain profiling of the 1q21.1 distal and 15q11.2 BP1-BP2 CNVs, with the potential to increase our understanding of mechanisms involved in altered neurodevelopment.

PMID:37661008 | DOI:10.1016/j.biopsych.2023.08.018

J Biomed Inform. 2023 Sep 1:104485. doi: 10.1016/j.jbi.2023.104485. Online ahead of print.

ABSTRACT

OBJECTIVE: We propose FedScore, a privacy-preserving federated learning framework for scoring system generation across multiple sites to facilitate cross-institutional collaborations.

MATERIALS AND METHODS: The FedScore framework includes five modules: federated variable ranking, federated variable transformation, federated score derivation, federated model selection and federated model evaluation. To illustrate usage and assess FedScore’s performance, we built a hypothetical global scoring system for mortality prediction within 30 days after a visit to an emergency department using 10 simulated sites divided from a tertiary hospital in Singapore. We employed a pre-existing score generator to construct 10 local scoring systems independently at each site and we also developed a scoring system using centralized data for comparison.

RESULTS: We compared the acquired FedScore model’s performance with that of other scoring models using the receiver operating characteristic (ROC) analysis. The FedScore model achieved an average area under the curve (AUC) value of 0.763 across all sites, with a standard deviation (SD) of 0.020. We also calculated the average AUC values and SDs for each local model, and the FedScore model showed promising accuracy and stability with a high average AUC value which was closest to the one of the pooled model and SD which was lower than that of most local models.

CONCLUSION: This study demonstrates that FedScore is a privacy-preserving scoring system generator with potentially good generalizability.

PMID:37660960 | DOI:10.1016/j.jbi.2023.104485

Biomed J. 2023 Sep 1:100656. doi: 10.1016/j.bj.2023.100656. Online ahead of print.

ABSTRACT

BACKGROUND: Peri-intubation cardiac arrest (PICA) is an uncommon yet serious complication of intubation. Although some associated risk factors have been identified, the results have been inconsistent. The aim of this study was to systematically review the relevant research and examine the associated risk factors of PICA through meta-analysis.

METHODS: Studies examining the risk factors for PICA before 1 Nov. 2022 were identified through searches in MEDLINE (OvidSP) and EMBASE. The reported adjusted or unadjusted odds ratios (ORs) and risk ratios (RRs) were recorded. We calculated pooled ORs and created forest plots using a random-effects model to identify the statistically significant risk factors. We assessed the certainty of evidence for each risk factor.

RESULTS: Eight studies were included in the meta-analysis. Pre-intubation hypotension, with a pooled OR of 4.96 (95% confidence interval [C.I.]: 3.75-6.57), pre-intubation hypoxemia, with a pooled OR of 4.43 (95% C.I.: 1.24-15.81), and two or more intubation attempts, with a pooled OR of 1.88 (95% C.I.: 1.09-3.23) were associated with a significantly higher risk of PICA. The pooled incidence of PICA was 2.1% (95% C.I.: 1.5%-3.0%).

CONCLUSIONS: Pre-intubation hypotension, hypoxemia, and more intubation attempts are significant risk factors for PICA. The findings could help physicians identify patients at risk under the acute setting.

PMID:37660901 | DOI:10.1016/j.bj.2023.100656