Tag: nevin manimala

J Surg Res. 2023 Apr 24;289:121-128. doi: 10.1016/j.jss.2023.03.027. Online ahead of print.

ABSTRACT

BACKGROUND: The topics of healthcare for lesbian, gay, bisexual, transgender, and queer (LGBTQ+) patients and inclusion of LGBTQ+ health providers remain overlooked. Some specialties may be perceived as less inclusive to LGBTQ+ trainees. This study aimed to describe the perspectives of current medical students regarding LGBTQ+ education and the acceptance of LGBTQ+ trainees among different specialties.

MATERIALS AND METHODS: A cross-sectional voluntary and anonymous online survey was distributed through REDCap to all medical students (n = 495) at a state medical school. Medical students’ sexuality and gender identity were queried. A descriptive statistical analysis was performed, and the responses were classified into two groups: LGBTQ+ and non-LGBTQ+.

RESULTS: A total of 212 responses were queried. Of the respondents who agreed that certain specialties are less welcoming to LGBTQ+ trainees (n = 69, 39%), orthopedic surgery, general surgery and neurosurgery were identified most frequently (84%, 76%, and 55%, respectively). After analyzing sexual orientation as an influence on choosing a future specialty for residency, only 1% of non-LGBTQ+ students indicated that their sexual orientation influences their specialty of choice in comparison with 30% of LGBTQ+ students (P < 0.001). Finally, more non-LGBTQ+ students indicated that they believe they are receiving appropriate education on caring for LGBTQ+ patients as compared to LGBTQ+ students (71% and 55%, respectively, P < 0.05).

CONCLUSIONS: LGBTQ+ students are still hesitant to pursue careers in General Surgery as compared to their non-LGBTQ+ peers. The perception that surgical specialties are the least welcoming to LGBTQ+ students continues to be a concern for all students. Further strategies of inclusivity and their effectiveness need to be studied.

PMID:37099822 | DOI:10.1016/j.jss.2023.03.027

Pancreas. 2022 Nov-Dec 01;51(10):1427-1433. doi: 10.1097/MPA.0000000000002183. Epub 2023 Mar 7.

ABSTRACT

OBJECTIVES: RING finger protein 26 (RNF26) plays an essential role in determining malignant tumor growth, whereas the role of which in pancreatic cancer (PC) has not been reported. This study aimed to investigate the role of RNF26 in PC cells.

METHODS: The Gene Expression Profiling Interactive Analysis was applied to study the role of RNF26 in malignant tumors. The in vitro or in vivo cell proliferation assays were used to investigate the role of RNF26 on the PC. The protein-protein interaction network analysis was used to search the binding partner of RNF26. The Western blot was used to reveal whether RNF26 promoted RNA binding motif protein-38 (RBM38) degradation in PC cells.

RESULTS: The Gene Expression Profiling Interactive Analysis tool showed that RNF26 was overexpressed in PC. Repressing RNF26 expression decreased PC cells growth, but overexpression of RNF26 increased PC proliferation. Furthermore, we demonstrated RNF26 degraded RBM38 to promote PC cell proliferation.

CONCLUSIONS: RNF26 was abnormally increased in PC, and upregulated RNF26 was correlated with a poor prognosis. RNF26 enhanced PC proliferation by inducing RBM38 degradation. We identified a novel RNF26-RBM28 axis involved in the progression of PC.

PMID:37099788 | DOI:10.1097/MPA.0000000000002183

Pancreas. 2022 Nov-Dec 01;51(10):1292-1299. doi: 10.1097/MPA.0000000000002208.

ABSTRACT

OBJECTIVES: For population databases, multivariable regressions are established analytical standards. The utilization of machine learning (ML) in population databases is novel. We compared conventional statistical methods and ML for predicting mortality in biliary acute pancreatitis (biliary AP).

METHODS: Using the Nationwide Readmission Database (2010-2014), we identified patients (age ≥18 years) with admissions for biliary AP. These data were randomly divided into a training (70%) and test set (30%), stratified by the outcome of mortality. The accuracy of ML and logistic regression models in predicting mortality was compared using 3 different assessments.

RESULTS: Among 97,027 hospitalizations for biliary AP, mortality rate was 0.97% (n = 944). Predictors of mortality included severe AP, sepsis, increasing age, and nonperformance of cholecystectomy. Assessment metrics for predicting the outcome of mortality, the scaled Brier score (odds ratio [OR], 0.24; 95% confidence interval [CI], 0.16-0.33 vs 0.18; 95% CI, 0.09-0.27), F-measure (OR, 43.4; 95% CI, 38.3-48.6 vs 40.6; 95% CI, 35.7-45.5), and the area under the receiver operating characteristic (OR, 0.96; 95% CI, 0.94-0.97 vs 0.95; 95% CI, 0.94-0.96) were comparable between the ML and logistic regression models, respectively.

CONCLUSIONS: For population databases, traditional multivariable analysis is noninferior to ML-based algorithms in predictive modeling of hospital outcomes for biliary AP.

PMID:37099769 | DOI:10.1097/MPA.0000000000002208

Ultrasound Obstet Gynecol. 2023 Apr 26. doi: 10.1002/uog.26234. Online ahead of print.

ABSTRACT

OBJECTIVES: The incidence of gestational diabetes mellitus (GDM) is increasing and is associated with adverse maternal, fetal and neonatal outcomes. Arterial stiffness (AS) is raised in pregnancies complicated by placental-mediated diseases such as pre-eclampsia. We investigated if AS is different between healthy pregnancies and women with GDM on different treatment modalities.

METHODS: We conducted a prospective longitudinal cohort study to assess and compare AS in pregnancies complicated by GDM with low-risk controls. AS, measured by pulse wave velocity (PWV) and brachial (BrAIx) and aortic (AoAIx) augmentation Index, was recorded using the Arteriograph® at four gestational windows: 24+0 to 27+6; 28+0 to 31+6; 32+0 to 35+6 and ≥36+0 weeks of gestation (windows W1-W4, respectively). Women with GDM were considered both as a single group, and as subgroups defined by treatment modality. Data were analyzed using a linear mixed model on each AS variable (log-transformed) with group, gestational windows, maternal age, ethnicity, parity, body mass index, mean arterial pressure and heart rate as fixed effects and individual as a random effect. We compared the group means including relevant contrasts and adjusted the p-values using the Bonferroni correction.

RESULTS: The study population comprised 155 low-risk controls and 127 with GDM, of whom 59 were treated with dietary intervention, 47 with metformin alone and 21 with metformin plus insulin. The two-way interaction term of study group and gestational age was significant for BrAIx and AoAIx (p<0.001), though there was no evidence (p=0.729) that mean AoPWV was different between the study groups. Women in the control group demonstrated significantly lower BrAIx and AoAIX at gestational windows W1-3 compared to the combined GDM group, but not at W4. Mean (95% CI) difference in log adjusted BrAIx was -0.37 (-0.52, 0.22), -0.23 (-0.35, -0.12), and -0.29 (-0.40, -0.18) at W1, W2 and W3, respectively. Mean (95% CI) difference in log adjusted AoAIx was -0.49 (-0.69, -0.3), -0.32 (-0.47, -0.18) and -0.38 (-0.52, -0.24) at W1, W2 and W3, respectively. Similarly, women in the control group also demonstrated significantly lower BrAIx and AoAIx compared with each of the GDM treatment subgroups (diet, metformin and metformin plus insulin) at W1-3. The increase in mean BrAIx and AoAIx seen between W2 and W3 in the women with GDM treated with dietary management was attenuated in the metformin and metformin with insulin groups, however the mean differences in BrAIx and AoAIx between these treatment groups were not statistically significant at any gestational window.

CONCLUSIONS: Pregnancies complicated by GDM demonstrate significantly higher AS compared to low-risk pregnancies regardless of treatment modality. Our data provides a basis for further investigation into the association of metformin therapy with changes in AS and risk of placental-mediated diseases. This article is protected by copyright. All rights reserved.

PMID:37099764 | DOI:10.1002/uog.26234

J Crohns Colitis. 2023 Apr 26:jjad075. doi: 10.1093/ecco-jcc/jjad075. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Technological advances have provided innovative, adaptive, and responsive models of care for inflammatory bowel diseases (IBD). We conducted a systematic review to compare e-health interventions with standard care in management of IBD.

METHODS: We searched electronic databases for randomized controlled trials (RCT) comparing e-health interventions to standard care for patients with IBD. Effect measures were standardized mean difference (SMD), odds ratio (OR) or rate ratio (RR), calculated using the inverse variance or Mantel-Haenszel statistical method and random-effects models. Version 2 of the Cochrane tool was used to assess the risk of bias. The certainty of evidence was appraised with the GRADE framework.

RESULTS: Fourteen RCTs (n=3111; 1754-e-health & 1357-controls) were identified. The difference in disease activity scores (SMD 0.09, 95% CI: -0.09-0.28) and clinical remission (OR 1.12, 95% CI: 0.78-1.61) between e-health interventions and standard care were not statistically significant. Higher QoL (SMD 0.20, 95% CI: 0.05-0.35) and IBD knowledge (SMD 0.23, 95% CI: 0.10-0.36) scores were noted in the e-health group, while self-efficacy levels (SMD -0.09, 95% CI: -0.22-0.05) were comparable. E-health patients had fewer office (RR 0.85, 95% CI: 0.78-0.93) and emergency (RR 0.70, 95% CI: 0.51- 0.95) visits, with no statistically significant difference in endoscopic procedures, total healthcare encounters, corticosteroid use, and IBD related hospitalization or surgery. The trials were judged to be high risk of bias or have some concerns for disease remission. The certainty of evidence was moderate or low.

CONCLUSION: E-health technologies may have a role in value-based care in IBD.

PMID:37099723 | DOI:10.1093/ecco-jcc/jjad075

Med Oral Patol Oral Cir Bucal. 2023 Apr 26:25889. doi: 10.4317/medoral.25889. Online ahead of print.

ABSTRACT

BACKGROUND: Oral squamous cell carcinoma (OSCC) is gradually increasing its incidence in our society. Unfortunately, this entity is diagnosed at an advanced stage in most patients, a fact that implies greater difficulty in its treatment and a worse prognosis. This systematic review aims to assess whether the cytokines IL-6, IL-8 and TNF-α are potential salivary biomarkers that allow early diagnosis of cancer.

MATERIAL AND METHODS: An electronic search was performed in three databases (Pubmed, Scopus and Web of Science). We used the following keywords: “salivary cytokines”, “saliva cytokines”, “salivary interleukins”, “biomarkers”, “oral squamous cell carcinoma” and “diagnosis”, combined with the Boolean operators “AND” and “OR”.

RESULTS: 128 publications were found and finally 23 articles were included in the review and 15 in the meta-analysis. It has been observed that the majority of OSCC patients express higher salivary concentrations of IL-6, IL-8 and TNF-α compared to the control (CL) and premalignant lesion (OPML) groups. It has also been observed that the different premalignant lesions do not have statistically significant differences in the salivary concentration of the cytokines, and on the other hand, differences have been observed between the different TNM stages. The meta-analysis has shown that the difference in concentration of IL-6, IL-8 and TNF-α is statistically significant between the CL group and the OSCC, and also between the CL group and OPML.

CONCLUSIONS: There is sufficient evidence to affirm that IL-6, IL-8 and TNF-α are useful salivary cytokines in the early diagnosis and prognosis of OSCC. Although future studies are necessary to establish greater reliability of these biomarkers and thus be able to develop a valid diagnostic test.

PMID:37099710 | DOI:10.4317/medoral.25889

Med Oral Patol Oral Cir Bucal. 2023 Apr 26:25997. doi: 10.4317/medoral.25997. Online ahead of print.

ABSTRACT

BACKGROUND: Evaluating 2-years implant loss and marginal bone loss in patients with hereditary coagulopathies, comparing with a healthy control group.

MATERIAL AND METHODS: 37 implants in 13 patients (17 haemophilia A, 20 Von-Willebrand disease) versus 26 implants in 13 healthy patients. Data measured through Lagervall-Jansson index (after surgery, at prosthetic loading, at 2 years).

STATISTICS: Chi-square, Haberman’s, ANOVA, Mann-Whitney-U. Significance p<0.05.

RESULTS: Haemorrhagic accidents in 2 coagulopathies patients (non-statistical differences). Hereditary coagulopathies patients suffered more hepatitis (p<0.05), HIV (p<0.05) and less previous periodontitis (p<0.01). Non-statistical differences in marginal bone loss among groups. 2 implants were lost in the hereditary coagulopathies and none in the control group (non-statistical differences). Hereditary coagulopathies patients had longer (p<0.001), and narrower implants (p<0.05) placed. 43.2% external prosthetic connection in hereditary coagulopathies patients (p<0.001); change of prosthetic platform more frequent in control group (p<0.05). 2 implants lost: external connection (p<0.05). Survival rate 96.8% (hereditary coagulopathies 94.6%, control group 100%).

CONCLUSIONS: Implant and marginal bone loss at 2 years is similar in patients with hereditary coagulopathies and control group. Precautions should be taken on the treatment for hereditary coagulopathies patients, through prior haematological protocol. Implant loss only occurred in in a patient with Von-Willebrand´s disease.

PMID:37099709 | DOI:10.4317/medoral.25997

Med Oral Patol Oral Cir Bucal. 2023 Apr 26:25917. doi: 10.4317/medoral.25917. Online ahead of print.

ABSTRACT

BACKGROUND: The aim of the present study was to calibrate the Periotron® model 8010 with volumes of three different fluids (distilled water, serum, and saliva) and to identify which of the three is the most reliable, feasible, and reproducible for routine calibration.

MATERIAL AND METHODS: A total of 450 samples of Periopaper® were divided into three groups (150 each per group): distilled water, serum matrix and saliva. A calibration curve was run with 0.25, 0.50, 0.75, 1.00 and 1.25 µl of each of the fluids, and the results were determined in Periotron units (PU). Statistical analysis was performed with one-way ANOVA followed by Bonferroni’s post hoc test and a linear equation.

RESULTS: Distilled water presented the lowest levels of PU at all volumes, while serum showed the highest levels at high volumes. Linear regression equations rendered similar slopes for saliva and distilled water, while serum was statistically different. Saliva presented a reproduction percentage of 99.7%, which indicated better accuracy and precision than serum and distilled water.

CONCLUSIONS: Saliva is more reliable and accurate than water or serum for the purpose of calibration of the Periotron® model 8010, though it shares drawbacks with serum. Distilled water is more easily available and does not require any additional procedure, in addition to producing a similar slope to saliva and a smaller deviation from the media than serum.

PMID:37099707 | DOI:10.4317/medoral.25917

Med Oral Patol Oral Cir Bucal. 2023 Apr 26:24852. doi: 10.4317/medoral.24852. Online ahead of print.

ABSTRACT

BACKGROUND: The purpose of this study was to evaluate the effect of a single-dose intravenous dexketoprofen administration for preventive analgesia on postoperative pain and reducing swelling in double jaw surgery.

MATERIAL AND METHODS: The authors designed a prospective, randomized, and double-blind cohort study. Patients who have Class III malocclusion were randomly divided in two groups. 50 mg intravenous dexketoprofen trometamol were administrated 30 minutes before incision in treatment group, while intravenous sterile saline was administrated 30 minutes before incision in placebo group. The primary predictor variable was treatment group. Primary outcomes were pain, swelling and 24-hour opioid intake. Patient- controlled analgesia with tramadol was given for management of postoperative pain. Other variables were demographic and operation related parameters. Visual analogue scale was used to evaluate postoperative pain. 3dMD Face System (3dMD, USA) was used to measure postoperative swelling. Data were analysed using two independent samples t test and Mann Whitney U test.

RESULTS: The study sample was composed of 30 patients with a mean age of 20,63 years and 21 were female. Preemptive dexketoprofen administration decreased postoperative tramadol consumption by 25.9% compared to placebo group, and there was a statistically significant decrease in VAS scores (p<0,05). There was no statistically significant difference between the groups in terms of swelling (p>0,05).

CONCLUSIONS: Preventive administration of intravenous dexketoprofen provides adequate analgesic effect in the postoperative 24-hour period and reduces opioid consumption in orthognathic surgery.

PMID:37099706 | DOI:10.4317/medoral.24852

Brief Bioinform. 2023 Apr 25:bbad158. doi: 10.1093/bib/bbad158. Online ahead of print.

ABSTRACT

Studies have found that human microbiome is associated with and predictive of human health and diseases. Many statistical methods developed for microbiome data focus on different distance metrics that can capture various information in microbiomes. Prediction models were also developed for microbiome data, including deep learning methods with convolutional neural networks that consider both taxa abundance profiles and taxonomic relationships among microbial taxa from a phylogenetic tree. Studies have also suggested that a health outcome could associate with multiple forms of microbiome profiles. In addition to the abundance of some taxa that are associated with a health outcome, the presence/absence of some taxa is also associated with and predictive of the same health outcome. Moreover, associated taxa may be close to each other on a phylogenetic tree or spread apart on a phylogenetic tree. No prediction models currently exist that use multiple forms of microbiome-outcome associations. To address this, we propose a multi-kernel machine regression (MKMR) method that is able to capture various types of microbiome signals when doing predictions. MKMR utilizes multiple forms of microbiome signals through multiple kernels being transformed from multiple distance metrics for microbiomes and learn an optimal conic combination of these kernels, with kernel weights helping us understand contributions of individual microbiome signal types. Simulation studies suggest a much-improved prediction performance over competing methods with mixture of microbiome signals. Real data applicants to predict multiple health outcomes using throat and gut microbiome data also suggest a better prediction of MKMR than that of competing methods.

PMID:37099694 | DOI:10.1093/bib/bbad158