Tag: nevin manimala

Eur J Drug Metab Pharmacokinet. 2023 May 15. doi: 10.1007/s13318-023-00829-5. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Lu-177 DOTATATE (Lutathera^®) is a radiolabeled analog of somatostatin administered intravenously in patients with somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors. Biodistribution of Lu-177 DOTATATE in tumor and healthy tissues can be monitored by serial post-injection scintigraphy imaging. Patient exposure to the drug is variable with the recommended fixed dosage, and hence there is a variable response to treatment. The aim of this work was to study the pharmacokinetics of Lu-177 DOTATATE by a population modeling approach, based on single-photon emission computed tomography (SPECT)/computed tomography (CT) images used as surrogate of plasma concentrations to study the interindividual variability and finally optimize an individual dosage.

METHODS: From a retrospective study, SPECT/CT images were acquired at 4 h, 24 h, 72 h, and 192 h postadministration. From these images, volumic activities were calculated in blood and bone marrow. An individual non-compartmental pharmacokinetic analysis was performed, and the mean pharmacokinetic parameters of each tissue were compared together and with reference data. Blood volumic activities were then used to perform a population pharmacokinetic analysis (NONMEM).

RESULTS: The pharmacokinetic parameters (non-compartmental analysis) obtained from blood (clearance [CL] = 2.65 L/h, volume of distribution at steady state [Vss] = 309 L, elimination half-life [t_1/2] = 86.3 h) and bone marrow (CL =1.68 L/h, Vss = 233 L, t_1/2 = 98.8 h) were statistically different from each other and from reference values (CL = 4.50 L/h, Vss = 460 L, t_1/2 = 71.0 h) published in the literature. SPECT/CT blood images were used as a surrogate of plasma concentrations to develop a population pharmacokinetic model. Weight was identified as covariate on volume of the central compartment, reducing the interindividual variability of all population pharmacokinetic parameters.

CONCLUSION: This study is a proof of concept that obtaining pharmacokinetic parameters with image-based blood concentration is possible. Obtaining observed concentrations from SPECT/CT images, without the need for blood sampling, is a real advantage for the patient and the drug monitoring. Pharmacokinetic modeling could be combined with a deep learning model for automatic contouring and allow precise patient-specific dose adjustment in a non-invasive manner.

PMID:37184824 | DOI:10.1007/s13318-023-00829-5

Environ Monit Assess. 2023 May 15;195(6):670. doi: 10.1007/s10661-023-11206-9.

ABSTRACT

This study integrates multivariate statistical analysis and hydrogeochemical modeling to investigate the processes controlling the groundwater composition of a shallow aquifer where increased pumping rates and anthropogenic impacts were prevalent. Eighteen groundwater samples were collected and analyzed for major elements and selected heavy metals. The data were classified on the basis of multivariate statistical analysis into three clusters: C1 (Na-Cl facies), C2 (Ca-SO₄ facies), and C3 (Ca-HCO₃ facies). The application of factor analysis gave four factors affecting the groundwater chemistry, namely the salinization factor, anthropogenic/secondary enrichment factor, the secondary and the micro-nutrient fertilizers, and the aluminum fertilizer factor. The hydrogeochemical study of the groundwater revealed that the processes controlling the groundwater chemistry in the study area are mainly affected by the groundwater occurrence either to the east or to the west of Bahr Youssef Canal. Generally, the dominant hydrogeochemical processes affecting the groundwater are silicate weathering, ion exchange, irrigation return flow, gypsum applications in soil, and evaporation. The groundwater quality evaluation shows that water quality varies from fair to excellent for drinking purposes, where the best water is located in the northern and central parts of the study area. The suitability of groundwater for irrigation was evaluated using several indices indicating that groundwater is suitable for irrigation in the northwest and western parts of the study area. As some groundwater samples lie in high salinity classes on the US Salinity diagram, it is recommended to use this water for plants with good salt tolerance under good drainage conditions. The integration between the statistical and geochemical tools helps reveal the dominant processes through data reduction and classification.

PMID:37184807 | DOI:10.1007/s10661-023-11206-9

Int Ophthalmol. 2023 May 15. doi: 10.1007/s10792-023-02720-3. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the efficacy of a comprehensive surgical approach in rejuvenating the aging upper periorbita.

METHODS: Three hundred and twenty eyes of 160 patients who were treated for dermatochalasis(D), eyebrow ptosis (EP) and blepharoptosis (BP) were included in the study. One hundred and ninety-eight patients had only dermatochalasis, 74 patients had D and EP, 39 patients had D and BP, 7 patients had D, EP and BP and 2 patients had D, EP and blepharospasm. The patients were evaluated before surgery, at 1 week, 1 month and 6 months after surgery. Dermatochalasis was scored between 0 and 3 points according to upper lid laxity and IP drooping. EP was scored between 0 and 2 points as normal, lateral EP and total EP. Aging was classified as mild in those with a total score of less than 3 points, moderate in those with a score of 3-6 and severe in those above 6 points.

RESULTS: Of the patients, 121 were female and 39 were male, with a mean age of 52 (40-87) years. The surgeries were performed as follows: upper eyelid blepharoplasty (UEB) 197(61.6%) patients, UEB + browpexy(B) 77(24.1%) patients, UEB + B + levator resection(LR) 7(2.2%) and UEB + LR 39 (12.2%) patients. While a statistically significant improvement was observed in patients who underwent UEB + B (p < 0.001), postoperative improvements were not found statistically significant compared to preoperative scores in other surgeries. The postsurgical scores showed statistically significant improvement in all age groups (p < 0.001).

CONCLUSIONS: A comprehensive surgical treatment can provide effective results in upper periorbital rejuvenation for patients with varying degrees of upper periorbital aging.

PMID:37184806 | DOI:10.1007/s10792-023-02720-3

Environ Sci Pollut Res Int. 2023 May 15. doi: 10.1007/s11356-023-27499-9. Online ahead of print.

ABSTRACT

The construction of National Industrial Relocation Demonstration Zones (NIRDZ) is important for China’s industrial transfer, but its environmental influence cannot be neglected. This study explores the environmental effects of industrial transfers by studying China’s NIRDZ. By employing panel data of 284 cities in China between 2005 and 2019, we compare environmental quality changes over time in areas with and without demonstration zones based on the staggered difference-in-differences (DD) technique. The results demonstrate a 0.032 increase in the environmental quality level of industrial receivers after the implementation of demonstration zones. The effect of demonstration zones on environmental improvement is moderated by natural resources, capital accumulation, and technological innovation capabilities. This impact is more fully realized in cities with resource-based, low-capital accumulation, and high-tech innovation but is not statistically significant difference at various levels of human resources. The environmental improvement effect of the NIRDZ is powerful in central cities and small- and medium-sized cities instead of western regions and large-scale cities. Additionally, mediation analysis is adopted to assess the potential mechanism between the association of NIRDZ and the environment. The demonstration area negatively affects environmental quality through the economic scale effect while improving environmental quality through the technological innovation effect. We provide empirical evidence that the NIRDZ is positively correlated with the environment and identify the technology effect as one underlying driver of this correlation to help developing countries address its detrimental impacts.

PMID:37184795 | DOI:10.1007/s11356-023-27499-9

Ir J Med Sci. 2023 May 15. doi: 10.1007/s11845-023-03375-w. Online ahead of print.

ABSTRACT

BACKGROUND: Visceral Adiposity Index (VAI) is a gender-specific mathematical model based on BMI, waist circumference (WC) and lipid parameters. No study has yet examined the relationship between this index and the glycemic and metabolic parameters in children and adolescents with Type 1 Diabetes Mellitus (DM). The current study aims at examining the relationship between glycemic and metabolic control and VAI in children and adolescents with Type 1 DM.

METHODS: A total of 150 children and adolescents aged 6-18 years with Type 1 DM were included in this study. Anthropometric, glycemic and metabolic parameters were examined. VAI was calculated using gender-specific formulas. Statistical analysis was done by SPSS version 23.

RESULTS: The average age of the participants was 12.2 ± 3.1 years (females 53.0%). The females had higher rates of VAI, microalbuminuria and hypertension than males. Participants of both gender with higher VAI quartiles had higher anthropometric measurements, insulin usage, low-density lipoprotein cholesterol (LDL-C), triglycerides and urine microalbumin and had poor glycemic control. Sex adjusted correlation analysis showed that VAI is negatively correlated with estimated glucose disposal rate (eGDR), and positively correlated with insulin dose, LDL-C, triglycerides, glycosylated hemoglobin (HbA1c) and microalbuminuria.

CONCLUSION: The present paper is the first study examining the relationship between Type 1 DM and VAI. Higher VAI values in children and adolescents with type 1 DM may adversely affect glycemic and metabolic control. VAI can be a useful and new method in evaluating glycemic and metabolic control in children and adolescents with Type 1 DM.

PMID:37184780 | DOI:10.1007/s11845-023-03375-w

Tech Coloproctol. 2023 May 15. doi: 10.1007/s10151-023-02812-3. Online ahead of print.

ABSTRACT

PURPOSE: Sarcopenia is associated with poor short- and long-term patient outcomes following colorectal surgery. Despite postoperative ileus (POI) being a major complication following colorectal surgery, the predictive value of sarcopenia for POI is unclear. We assessed the association between sarcopenia and POI in patients with colorectal cancer.

METHODS: Elective colorectal cancer surgery patients were retrospectively included (2018-2022). The cross-sectional psoas area was calculated using preoperative staging imaging at the level of the 3rd lumbar vertebrae. Sarcopenia was determined using gender-specific cut-offs. The primary outcome POI was defined as not achieving GI-2 by day 4. Demographics, operative characteristics, and complications were compared via univariate and multivariate analyses.

RESULTS: Of 297 patients, 67 (22.6%) were sarcopenic. Patients with sarcopenia were older (median 74 (IQR 67-82) vs. 69 (58-76) years, p < 0.001) and had lower body mass index (median 24.4 (IQR 22.2-28.6) vs. 28.8 (24.9-31.9) kg/m², p < 0.001). POI was significantly more prevalent in patients with sarcopenia (41.8% vs. 26.5%, p = 0.016). Overall rate of complications (85.1% vs. 68.3%, p = 0.007), Calvien-Dindo grade > 3 (13.4% vs. 10.0%, p = 0.026) and length of stay were increased in patients with sarcopenia (median 7 (IQR 5-12) vs. 6 (4-8) days, p = 0.013). Anastomotic leak rate was higher in patients with sarcopenia although the difference was not statistically significant (7.5% vs. 2.6%, p = 0.064). Multivariate analysis demonstrated sarcopenia (OR 2.0, 95% CI 1.1-3.8), male sex (OR 1.9, 95% CI 1.0-3.5), postoperative hypokalemia (OR 3.2, 95% CI 1.6-6.5) and increased opioid use (OR 2.4, 95% CI 1.3-4.3) were predictive of POI.

CONCLUSION: Sarcopenia demonstrates an association with POI. Future research towards truly identifying the predictive value of sarcopenia for postoperative complications could improve informed consent and operative planning for surgical patients.

PMID:37184771 | DOI:10.1007/s10151-023-02812-3

Neurosurg Rev. 2023 May 15;46(1):120. doi: 10.1007/s10143-023-02029-w.

ABSTRACT

Geniculate ganglion hemangioma (GGH) is rarely presented in the neurosurgical literature. It extends extradurally on the middle fossa floor and displaces the intratemporal part of the facial nerve. Surgical treatment is advisable at early symptoms. Proposed techniques include fascicular-sparing resection or nerve interruption with grafting. No definitive conclusions exist about the superiority of a certain technique in preserving facial nerve integrity and function. Through the description of a surgically managed symptomatic GGH, we herein discuss literature data about the surgical results of fascicular-sparing resection versus grafting. A PRISMA-based literature search was performed on the PubMed database. Only articles in English and published since 1990 were selected and furtherly filtered based on the best relevance. Statistical comparisons were performed with ANOVA. One hundred sixteen GGHs were collected, 56 were treated by fascicular-sparing resection, and 60 were treated by grafting. The facial function was improved, or unchanged, in 53 patients of the fascicular-sparing group and 30 patients of the grafting one. Sixty-five patients achieved a good (House-Brackmann (HB) grade III) postoperative facial outcome, of which 47 and 18 belonged to the fascicular-sparing and grafting group, respectively. Greater efficacy of the fascicular-sparing technique in the achievement of a better facial outcome was found (p = 0.0014; p = 0.0022). A surgical resection at the earliest symptoms is critical to preserve the facial nerve function in GGHs. Fascicular-sparing resection should be pursued in symptomatic cases with residual facial function (I-III HB). Conversely, grafting has a rationale for higher HB grades (V-VI). Broader studies are required to confirm these findings and turn them into new therapeutic perspectives.

PMID:37184718 | DOI:10.1007/s10143-023-02029-w

J Cancer Res Clin Oncol. 2023 May 15. doi: 10.1007/s00432-023-04836-6. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the preoperative value of serum SCC-Ag in predicting the stromal invasion of cervical squamous cell carcinoma.

METHODS: This study retrospectively analyzed 78 patients with early cervical squamous cell carcinoma who underwent surgery as initial treatment at the Senior Department of Obstetrics and Gynecology, the Seventh Medical Center of PLA General Hospital from January 2018 to September 2022 was implemented. The clinicopathological characteristics were statistically compared. The ROC curve was drawn to determine the optimal critical level of preoperative serum SCC-Ag value for predicting cervical stromal invasion.

RESULTS: The depth of myometrial invasion was not related to the age of diagnosis and HPV infection (p > 0.05), while it was related to tumor size, staging, tissue differentiation, LVSI, lymph node metastasis (LNM) and preoperative serum SCC-Ag value (p < 0.05).The area under the curve (AUC) of serum SCC-Ag value was 0.894 (p = 0.000, 95% CI 0.824-0.964), and preoperative serum SCC-Ag value 1.65 ng/ml was the best cutoff for predicting cervical stromal invasion in cervical squamous cell carcinoma. The sensitivity and specificity of diagnosis were 92.3% and 78.8%, respectively.

CONCLUSION: If the preoperative serum SCC-Ag leval more than 1.65 ng/ml in patients with cervical squamous cell carcinoma, the risk of cervical stromal invasion will increase, which can provide a reference for clinical treatment.

PMID:37184678 | DOI:10.1007/s00432-023-04836-6

Adv Health Sci Educ Theory Pract. 2023 May 15. doi: 10.1007/s10459-023-10232-z. Online ahead of print.

ABSTRACT

Visual (perceptual) reasoning is a critical skill in many medical specialties, including pathology, diagnostic imaging, and dermatology. However, in an ever-compressed medical curriculum, learning and practicing this skill can be challenging. Previous studies (including work with pigeons) have suggested that using reward-feedback-based activities, novices can gain expert levels of visual diagnostic accuracy in shortened training times. But is this level of diagnostic accuracy a result of image recognition (categorization) or is it the acquisition of diagnostic expertise? To answer this, the authors measured electroencephalographic data (EEG) and two components of the human event-related brain potential (reward positivity and N170) to explore the nature of visual expertise in a novice-expert study in pathology visual diagnosis. It was found that the amplitude of the reward positivity decreased with learning in novices (suggesting a decrease in reliance on feedback, as in other studies). However, this signal remained significantly different from the experts whose reward positivity signal did not change over the course of the experiment. There were no changes in the amplitude of the N170 (a reported neural marker of visual expertise) in novices over time. Novice N170 signals remained statistically and significantly lower in amplitude compared to experts throughout task performance. These data suggest that, while novices gained the ability to recognize (categorize) pathologies through reinforcement learning as quantified by the change in reward positivity, increased accuracy, and decreased time for responses, there was little change in the neural marker associated with visual expertise (N170). This is consistent with the multi-dimensional and complex nature of visual expertise and provides insight into future training programs for novices to bridge the expertise gap.

PMID:37184677 | DOI:10.1007/s10459-023-10232-z

Trop Anim Health Prod. 2023 May 15;55(3):198. doi: 10.1007/s11250-023-03629-w.

ABSTRACT

Exploring genetic variability by microsatellite markers is essential for genetic improvement, preservation of indigenous germplasm and production of high-quality offspring. Lack of information on microsatellite profiling of Indian indigenous ducks (Tripura state) has stoked curiosity in this work. Genomic DNA samples from randomly selected 36 native ducks were analysed at 25 duck-specific microsatellite loci. Alleles were separated through 3.4% MetaPhore™ agarose gel electrophoresis. Allele sizes were determined using Image Lab 6 software of GelDoc™ EZ System. Allelic data were analysed by POPGENE version 1.31. Total 112 alleles were resolved and all the loci were found polymorphic with 2 to 15 alleles across the loci. Average number of allele (N_a) was 4.480 ± 0.659. Allele sizes and frequencies ranged from 96 to 357 bp and 0.014 to 0.819, respectively. Average heterozygosity of Nei, effective number (N_e) of alleles and Shannon’s information index (I) were 0.617 ± 0.036, 3.538 ± 0.527 and 1.184 ± 0.112, respectively. The estimates of N_e were less than the N_a at all the loci, indicating prevalence of heterozygosity. Polymorphic information content (PIC) ranged from 0.252 (CAUD020) to 0.911 (CAUD019) with an average of 0.562 ± 0.040. Sixteen loci were moderate to highly polymorphic and informative (PIC ˃ 0.5). Chi-square and G-square statistics revealed Hardy-Weinberg disequilibrium at all the loci. Moderate to high level of polymorphism of the studied microsatellites indicated that these markers might be helpful for genetic characterisation and adoption of appropriate conservation strategies to exploit optimum genetic potentiality of indigenous ducks of Tripura.

PMID:37184669 | DOI:10.1007/s11250-023-03629-w