Tag: nevin manimala

Cancer Cell Int. 2023 Apr 16;23(1):72. doi: 10.1186/s12935-023-02918-6.

ABSTRACT

BACKGROUND: Accumulating evidence demonstrated that nuclear factor erythroid 2-related factor 2 (NRF2) expression plays a crucial role in the proliferation, invasion and metastasis of hepatocellular carcinoma (HCC). However, research on the effect of NRF2 genetic polymorphism on the development of chronic hepatitis B (CHB), HBV-related liver cirrhosis (LC) and HCC is still missing.

METHODS: A total of 673 individuals were included in the study and classified into four groups: 110 CHB cases, 86 LC cases, 260 HCC cases, and 217 healthy controls. ​The polymerase chain reaction-restriction fragment length polymorphism and DNA sequencing method were used to detect rs6721961 and rs6726395 polymorphisms.

RESULTS: Patients carrying the T allele in rs6721961 were at a higher risk of HCC than individuals with the G allele compared to CHB patients (OR = 1.561, 95%CI: 1.003-2.430, P = 0.048). The statistically significant differences were also found in the rs6721961 GT genotype (OR = 2.298, 95% CI: 1.282-4.119, P = 0.005) and dominant model (OR = 2.039, 95% CI: 1.184-0.510, P = 0.010). Subgroup analysis also detected a significant association between the rs6721961 T allele and the development of HCC in older subjects (≥ 50 years) (OR = 2.148, 95% CI: 1.208-3.818, P = 0.009). Statistical analysis results indicated that subjects carrying haplotype G-A had a lower risk of HCC (OR = 0.700, 95% CI: 0.508-0.965, P = 0.028).

CONCLUSIONS: For the first time, our findings provide evidence that the NRF2 gene rs6721961 variation is a potential genetic marker of susceptibility to HCC.

PMID:37062839 | DOI:10.1186/s12935-023-02918-6

BMC Endocr Disord. 2023 Apr 17;23(1):82. doi: 10.1186/s12902-023-01294-6.

ABSTRACT

BACKGROUND: Polycystic Ovary Syndrome (PCOS) is a very common endocrine disorder with a variety of symptoms. Current treatment options include the contraceptive pill as well as metformin, however both treatments are limited to specific symptoms and have common side effects.

METHODS: This phase IV study is a monocentric, double blinded randomized clinical trial comparing the effects of six months of probiotic intervention to a placebo, with an additional open-label metformin arm as a positive control in a total of 180 participants with PCOS. The first of three visits is the screening visit, where inclusion/exclusion criteria are assessed. At the first visit, they are randomised into one of the three treatment arms equally and receive their study medication. After six months, all assessments from the first two visits are repeated. The primary endpoint is the change in free testosterone levels after the intervention, while secondary endpoints include changes in hormonal and metabolic parameters associated with PCOS as well as the gut microbial composition and diversity after intervention.

DISCUSSION: Based on new insights into the role of the gut microbiome in PCOS development, this study is exploring the potential of using probiotics to treat women with PCOS symptoms. If successful, this new therapy approach could open a new realm of possibilities for treating PCOS. To our knowledge, this is the first study comparing probiotic intervention with not only placebo treatment, but also metformin. This study has been approved by the ethics committee of the Medical University of Graz (EC number 32-230 ex 19/20).

REGISTRATION: EudraCT number: 2020-000228-20.

CLINICALTRIALS: gov identifier: NCT04593459.

PROTOCOL VERSION: Version 1.5 dated 29th November 2021.

PMID:37062834 | DOI:10.1186/s12902-023-01294-6

Cogn Sci. 2023 Apr;47(4):e13272. doi: 10.1111/cogs.13272.

ABSTRACT

A central problem in the cognitive sciences is identifying the link between consciousness and neural computation. The key features of consciousness-including the emergence of representative information content and the initiation of volitional action-are correlated with neural activity in the cerebral cortex, but not computational processes in spinal reflex circuits or classical computing architecture. To take a new approach toward considering the problem of consciousness, it may be worth re-examining some outstanding puzzles in neuroscience, focusing on differences between the cerebral cortex and spinal reflex circuits. First, the mammalian cerebral cortex exhibits exascale computational power, a feature that is not strictly correlated with the number of binary computational units; second, individual computational units engage in noisy coding, allowing random electrical events to gate signaling outcomes; third, this noisy coding results in the synchronous firing of statistically random populations of cells across the neural network, at a range of nested frequencies; fourth, the system grows into a more ordered state over time, as it encodes the predictive value gained through observation; and finally, the cerebral cortex is extraordinarily energy efficient, with very little free energy lost to entropy during the work of information processing. Here, I argue that each of these five key features suggest the mammalian brain engages in probabilistic computation. Indeed, by modeling the physical mechanisms of probabilistic computation, we may find a better way to explain the unique emergent features arising from cortical neural networks.

PMID:37062806 | DOI:10.1111/cogs.13272

J Robot Surg. 2023 Apr 17. doi: 10.1007/s11701-023-01594-y. Online ahead of print.

ABSTRACT

In 2016, the American Thyroid Association published a statement on remote-access thyroid surgery claiming that it should be reserved to patients with thyroid nodule ≤ 3 cm, thyroid lobe < 6 cm and without thyroiditis. We retrospectively enrolled all patients who underwent robotic transaxillary thyroidectomy between February 2012 and March 2022. We compared surgical outcomes between patients who presented a thyroid gland with a nodule ≤ 3 cm, thyroid lobe < 6 cm and without thyroiditis (Group A) and patients without these features (Group B). The rate of overall complications resulted comparable (p = 0.399), as well as the operative time (p = 0.477) and the hospital stay (p = 0.305). Moreover, bleeding resulted associated to thyroid nodule > 3 cm (p = 0.015), although all bleedings but one occurred in the remote-access site from the axilla to the neck. In experienced hands, robotic transaxillary thyroidectomy is feasible and safe even in patients with large thyroid nodules or thyroiditis.

PMID:37062803 | DOI:10.1007/s11701-023-01594-y

Environ Sci Pollut Res Int. 2023 Apr 17. doi: 10.1007/s11356-023-26906-5. Online ahead of print.

ABSTRACT

Formaldehyde has carcinogenic properties. It is associated with nasopharyngeal cancer and causes irritation of the eyes, nose, throat, and respiratory system. Formaldehyde exposure is a significant health concern for those participating in the gross anatomy laboratory, but no learning method can substitute cadaver dissection. We performed a formaldehyde level study in 2018, which found that most of the breathing zone (S-level) and environment (R-level) formaldehyde levels during laboratory sessions at the Faculty of Medicine Siriraj Hospital exceeded international ceiling standards. In the academic year 2019, we adapted the engineering rationale of the NIOSH hierarchy of controls to facilitate formaldehyde clearance by opening the dissection table covers and increasing the area per dissection table, then measured formaldehyde ceiling levels by formaldehyde detector tube with a gas-piston hand pump during (1) body wall, (2) upper limb, (3) head-neck, (4) thorax, (5) spinal cord removal, (6) lower limb, (7) abdomen, and (8) organs of special senses dissection sessions and comparing the results with the 2018 study. The perineum region data were excluded from analyses due to the laboratory closure in 2019 from the COVID-19 outbreak. There were statistically significant differences between the 2018 and 2019 S-levels (p < 0.001) and R-levels (p < 0.001). The mean S-level decreased by 64.18% from 1.34 ± 0.71 to 0.48 ± 0.26 ppm, and the mean R-level decreased by 70.18% from 0.57 ± 0.27 to 0.17 ± 0.09 ppm. The highest formaldehyde level in 2019 was the S-level in the body wall region (1.04 ± 0.3 ppm), followed by the S-level in the abdomen region (0.56 ± 0.08 ppm) and the spinal cord removal region (0.51 ± 0.29 ppm). All 2019 formaldehyde levels passed the OSHA 15-min STEL standard (2 ppm). The R-level in the special sense region (0.06 ± 0.02 ppm) passed the NIOSH 15-min ceiling limit (0.1 ppm). Three levels for 2019 were very close: the R-level in the head-neck region (0.11 ± 0.08 ppm), the abdomen region (0.11 ± 0.08), the body wall region (0.14 ± 0.12 ppm), and the S-level in the special sense region (0.12 ± 0.04 ppm). In summary, extensive analysis and removal of factors impeding formaldehyde clearance can improve the general ventilation system and achieve the OSHA 15-min STEL standard.

PMID:37062795 | DOI:10.1007/s11356-023-26906-5

Eur J Hybrid Imaging. 2023 Apr 17;7(1):8. doi: 10.1186/s41824-023-00166-5.

ABSTRACT

BACKGROUND: In patients with increasing PSA and suspicion for prostate cancer, but previous negative biopsies, PET/MRI is used to test for tumours and target potential following biopsy. We aimed to determine different PSMA PET timing effects on signal kinetics and test its correlation with the patients’ PSA and Gleason scores (GS).

METHODS: A total of 100 patients were examined for 900 s using PET/MRI approximately 1-2 h p.i. depending on the tracer used (⁶⁸Ga-PSMA-11, ¹⁸F-PSMA-1007 or ¹⁸F-rhPSMA7). The scans were reconstructed in static and dynamic mode (6 equal frames capturing “late” PSMA dynamics). TACs were computed for detected lesions as well as linear regression plots against time for static (SUV) and dynamic (SUV, SUL, and percent injected dose per gram) parameters. All computed trends were tested for correlation with PSA and GS.

RESULTS: Static and dynamic scans allowed unchanged lesion detection despite the difference in statistics. For all tracers, the lesions in the pelvic lymph nodes and bones had a mostly negative activity concentration trend (78% and 68%, resp.), while a mostly positive, stronger trend was found for the lesions in the prostate and prostatic fossa following RPE (84% and 83%, resp.). In case of ⁶⁸Ga-PSMA-11, a strong negative (R_min = – 0.62, R_max = – 0.73) correlation was found between the dynamic parameters and the PSA. ¹⁸F-PSMA-1007 dynamic data showed no correlation with PSA, while for ¹⁸F-rhPSMA7 dynamic data, it was consistently low positive (R_min = 0.29, R_max = 0.33). All tracers showed only moderate correlation against GS (R_min = 0.41, R_max = 0.48). The static parameters showed weak correlation with PSA (R_min = 0.24, R_max = 0.36) and no correlation with GS.

CONCLUSION: “Late” dynamic PSMA data provided additional insight into the PSMA kinetics. While a stable moderate correlation was found between the PSMA kinetics in pelvic lesions and GS, a significantly variable correlation with the PSA values was shown depending on the radiotracer used, the highest being consistently for ⁶⁸Ga-PSMA-11. We reason that with such late dynamics, the PSMA kinetics are relatively stable and imaging could even take place at earlier time points as is now in the clinical routine.

PMID:37062775 | DOI:10.1186/s41824-023-00166-5

Sci Rep. 2023 Apr 16;13(1):6190. doi: 10.1038/s41598-023-33269-x.

ABSTRACT

Laparoscopic (LPD) and robotic pancreaticoduodenectomy (RPD) are both challenging procedures. The feasibility and safety of simultaneously developing LPD and RPD remain unreported. We retrospectively reviewed the data of patients undergoing LPD or RPD between 2014 and 2021. A total of 114 patients underwent minimally invasive pancreaticoduodenectomy (MIPD): 39 LPDs and 75 RPDs. The learning process of LPD and RPD were similar. The cutoff points of the learning curve were LPD, 13th patient (the 27th patient of MIPD), and RPD, 18th patient (the 31st patient of MIPD) according the cumulative sum analysis of operative time. A decrease in the operative time was associated with the case sequence (p < 0.001) but not with the surgical approach (p = 0.36). The overall surgical outcomes were comparable between both the LPD and RPD groups. When evaluating the learning curve impact on MIPD, LPD had higher major complication (≧ Clavien-Dindo grade III), bile leak and wound infection rates in the pre-learning curve phase than those in the after-learning curve phase, while RPD had similar surgical outcomes between two phases. Simultaneous development of LPD and RPD is feasible and safe for experienced surgeons, with similar learning process and comparable surgical outcomes.

PMID:37062774 | DOI:10.1038/s41598-023-33269-x

Eur Radiol. 2023 Apr 17. doi: 10.1007/s00330-023-09629-6. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the feasibility of 0.2-mm isotropic lenticulostriate arteries (LSAs) imaging using compressed sensing time-of-flight (CS TOF) at around 10 min on 7T, and compare the delineation and characterization of LSAs using conventional TOF and CS TOF.

METHODS: Thirty healthy volunteers were examined with CS TOF and conventional TOF at 7T for around 10 min each. CS TOF was optimized to achieve 0.2-mm isotropic LSA imaging. The numbers of LSA stems and branches were counted and compared on a vascular skeleton. The length and distance were measured and compared on the most prominent branch in each hemisphere. Another patient with intracranial artery stenosis was studied to compare LSA delineation in CS TOF and digital subtraction angiography (DSA).

RESULTS: The number of stems visualized with CS TOF was significantly higher than with conventional TOF in both left (p = 0.002, ICC = 0.884) and right (p < 0.001, ICC = 0.938) hemispheres. The number of branches visualized by conventional TOF was significantly lower than that by CS TOF in both left (p < 0.001, ICC = 0.893) and right (p < 0.001, ICC = 0.896) hemispheres. The lengths were statistically higher in CS TOF than in conventional TOF (left: p < 0.001, ICC = 0.868; right: p < 0.001, ICC = 0.876).

CONCLUSIONS: The high-resolution CS TOF improves the delineation and characterization of LSAs over conventional TOF. High-resolution LSA imaging using CS TOF can be a promising tool for clinical research and applications in patients with neurologic diseases.

KEY POINTS: • 0.2-mm isotropic LSA imaging for around 10 min using CS TOF at 7T is feasible. • More stems and branches of LSAs with longer lengths can be delineated with CS TOF than with conventional TOF at the same scan time. • High-resolution CS TOF can be a promising tool for research and applications on LSA.

PMID:37062772 | DOI:10.1007/s00330-023-09629-6

Pediatr Radiol. 2023 Apr 17. doi: 10.1007/s00247-023-05637-2. Online ahead of print.

ABSTRACT

BACKGROUND: Intracranial pressure (ICP) monitoring in children currently requires invasive techniques. Subharmonic aided pressure estimation (SHAPE) uses contrast-enhanced ultrasound (CEUS) to measure intravascular and interstitial pressure, but utility in ICP measurements has yet to be explored.

OBJECTIVE: The objective of this study was to investigate SHAPE as a novel tool for noninvasive ICP measurements in fetal lambs.

MATERIALS AND METHODS: Eighteen fetal lambs at 107-139 days gestational age (term = 145 days) underwent subdural ICP catheter placement. The brain was imaged in the coronal plane in CEUS mode optimized for SHAPE, while infusing an US contrast agent into the fetal circulation. After SHAPE calibration, saline was infused via the subdural catheter to increase ICP. Five-second SHAPE cine clips were obtained at various ICPs. Subharmonic intensity values of the whole brain and thalami were correlated with ICP values using mixed effects linear regression analyses and the strength of the relationship was evaluated by Spearman’s rank-order correlation.

RESULTS: Forty-nine experiments produced 723 datapoints, including SHAPE intensity values and mean ICP measurements. There was a statistically significant inverse relationship between SHAPE intensity values and ICP measurements in the whole brain and thalami (median rho value – 0.58 and – 0.56, respectively).

CONCLUSION: SHAPE intensity values of the brain demonstrate an inverse and statistically significant correlation with in vivo ICP measurements in an animal model.

PMID:37062765 | DOI:10.1007/s00247-023-05637-2

Psychogeriatrics. 2023 Apr 16. doi: 10.1111/psyg.12965. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to determine the effect of rumination and elder abuse levels on successful aging in elderly individuals.

METHODS: This descriptive-correlational study was conducted with older individuals (n = 297) in Ağrı, Turkey, between October 2021 and May 2022. SPSS-22 and R v.4.1.3 were used in the study. Analysis was done with machine learning and artificial neural networks.

RESULTS: In the study, the mean age of the older individuals was 67.49 ± 3.04. Statistical estimates showed the regression model to be significant and usable, F(2,294) = 116.659, P = 0.001. Elder abuse and ruminative thought levels together explained 43.9% of the total variance (R² = 0.439) of successful aging. The regression model indicated that increases in both the elder abuse level (t = -3.672, P < 0.001) and the ruminative thought level (t = -12.771, P < 0.001) of participants caused a statistically significant decrease in the successful aging level. The combined elder abuse and ruminative thought levels had a greater effect on successful aging (Model 1: F = 45.321, Model 2: F = 116.659, R² Change = 0.309). The R² value of the Random Forest regression model was 0.529, showing that the independent variables could explain 52.92% of the variation in the dependent variable. According to the SHapley Additive exPlanation values, which show the contribution or importance of each variable in the estimation of the model, it was determined that the most important variables for estimating the Successful Aging Scale variable were ruminative thought style and elder abuse screening.

CONCLUSIONS: Our study indicates that a decrease in the levels of rumination and elder abuse could lead to improvement in successful aging. Longitudinal studies on successful aging in older individuals are recommended.

PMID:37062761 | DOI:10.1111/psyg.12965