Tag: nevin manimala

Oral Oncol. 2021 Aug 14;121:105480. doi: 10.1016/j.oraloncology.2021.105480. Online ahead of print.

ABSTRACT

OBJECTIVES: The prognostic impact of circulating tumor cells (CTCs) or circulating tumor microemboli (CTM) in locally advanced head and neck squamous cell carcinoma (LA-HNSCC) is yet to be determined, with conflicting results in previous trials. The role of induction chemotherapy (ICT) in the management of LA-HNSCC is controversial with no predictive biomarkers to guide treatment strategy in this scenario. The aim of this trial is to determine the prognostic impact of CTCs and CTM, their biomarkers expression by immunocytochemistry (ICC), and its potential role as predictors of ICT benefit in LA-HNSCC.

MATERIALS AND METHODS: Prospective study, with newly diagnosed stage III/IV non-metastatic LA-HNSCC patients treated with curative intent. Blood samples analyzed for CTCs and CTM before treatment using the ISET method.

RESULTS: A total of 83 patients were included. CTCs counts were an independent prognostic factor for overall survival (OS; HR: 1.17; 95 %CI: 1.05-1.31; p = 0.005) and progression free survival (PFS; HR:1.14; 95 %CI: 1.03-1.26; p = 0.007). Using the Lausen and Schumacher technique, 2.8 CTCs/mL for OS and 3.8 CTCs/mL for PFS were defined as the best cut-offs. CTM were detected in 27.7% of patients, correlating with worse PFS (HR = 2.70; IC95%: 1.30-5.58; p = 0.007). MRP-7 expression in CTM correlated with worse OS (HR = 3.49; 95 %CI: 1.01-12.04; p = 0.047) and PFS (HR = 3.62; 95 %CI: 1.08-12.13; p = 0.037). CTCs counts were predictive of complete response to treatment (OR = 0.74; 95 %CI: 0.58-0.95; p = 0.022) and high counts (cut-off 3.8/mL) and CTM were potential predictors of ICT benefit.

CONCLUSION: CTCs/CTM had significant prognostic impact and potential role as predictors of ICT benefit in LA-HNSCC.

PMID:34403888 | DOI:10.1016/j.oraloncology.2021.105480

Anaesth Crit Care Pain Med. 2021 Aug 14:100939. doi: 10.1016/j.accpm.2021.100939. Online ahead of print.

ABSTRACT

PURPOSE: Neuraxial analgesia is effective and widely used during labour, but little is known about maternal satisfaction with its use. Our objectives were to assess the frequency of incomplete maternal satisfaction with neuraxial labour analgesia and its predictors.

METHODS: We extracted data from the 2016 National Perinatal Survey, a cross-sectional population-based study including all births during one week in all French maternity units. This analysis included all women who attempted vaginal delivery with neuraxial analgesia. Maternal satisfaction with analgesia was assessed by a 4-point Likert scale during a postpartum interview. Incomplete satisfaction grouped together women who were fairly, not sufficiently and not at all satisfied. We performed generalised estimating equations analyses adjusted for sociodemographic, obstetric, anaesthetic, and organisational characteristics to compare women with incomplete satisfaction to those completely satisfied.

RESULTS: Among the 8538 women included, 35.2% were incompletely satisfied with their neuraxial analgesia. The odds of incomplete satisfaction were higher among women who reported a prenatal preference not to use neuraxial analgesia but subsequently did (adjusted odds ratio 1.21; 95% confidence interval 1.05-1.39) and among those who did not use patient-controlled neuraxial analgesia (1.20; 1.07-1.34); the odds were lower among women who used combined spinal epidural analgesia (0.53; 0.28-0.99) than among those with epidural analgesia.

CONCLUSION: Incomplete maternal satisfaction with neuraxial analgesia is a frequent concern in France. Increasing the use of patient-controlled neuraxial analgesia and combined spinal-epidural analgesia, as well as consistency between prenatal preference and actual use of neuraxial analgesia may improve maternal satisfaction.

PMID:34403793 | DOI:10.1016/j.accpm.2021.100939

J Acad Nutr Diet. 2021 Aug 14:S2212-2672(21)01201-6. doi: 10.1016/j.jand.2021.08.105. Online ahead of print.

ABSTRACT

BACKGROUND: Cost is one of the main drivers of food selection, thus it is important to monitor food prices. Evidence from low- and middle-income countries such as Mexico is limited.

OBJECTIVE: The aim of this study was to evaluate the price and price trend of healthy and less healthy food/beverage groups in Mexico from 2011 to 2018.

DESIGN: This study used time series of the prices of foods and beverages classified by 1) healthiness, 2) processing level, and 3) pairs of healthy/less healthy substitutes.

SETTING: Food and beverage prices used to estimate the Consumer Price Index were obtained. Prices were collected weekly from 46 cities (>20,000 habitants) distributed across the country.

MAIN OUTCOME MEASURES: Price trend (% change/year) from 2011-2018 for all food/beverage groups and price/100 g in 2018 for pairs of healthy/less healthy substitutes were obtained.

STATISTICAL ANALYSES: Linear regression models were used for each food/beverage group with the logarithm of deflated price as the dependent variable and time (years) as the independent variable.

RESULTS: On average, prices for less healthy foods and beverages increased more than prices of healthy foods and beverages (foods: 1.72% vs. 0.70% change/year; beverages: 1.61% vs. -0.19% change/year). The price change was similar for unprocessed/minimally processed foods and ultra-processed foods (1.95% vs. 1.85% change/year), yet, within each processing category, the price of less healthy foods increased more. By pairs of substitutes (within food/beverage groups), the healthier option for bread, sodas, and poultry was more expensive (price/100g) in 2018, whereas for red meat, cheese, mayonnaise, and milk the healthier option was cheaper.

CONCLUSIONS: Overall, the food prices of less healthy foods and beverages increased more than the food prices of healthy foods and beverages. However, by processing level there was no difference and for pairs of healthy/less healthy substitutes results were mixed. Continued monitoring of food prices is warranted and future research is needed to understand how these price changes affect dietary quality.

PMID:34403815 | DOI:10.1016/j.jand.2021.08.105

Comput Methods Programs Biomed. 2021 Aug 10;209:106336. doi: 10.1016/j.cmpb.2021.106336. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: Rapid and precise diagnosis of COVID-19 is very critical in hotspot regions. The main aim of this proposed work is to investigate the baseline, laboratory and CT features of COVID-19 affected patients of two groups (Early and Critical stages). The detection model for COVID-19 is built depending upon the manifestations that define the severity of the disease.

METHODS: The CT scan images are fed into the various deep learning, machine learning and hybrid learning models to mine the necessary features and predict CT Score. The predicted CT score along with other clinical, laboratory and CT scan image features are then passed to train the various Regression models for predicting the COVID Criticality (CC) Score. These baseline, laboratory and CT features of COVID-19 are reduced using Statistical analysis and Univariate logistic regression analysis.

RESULTS: When analysing the prediction of CT scores using images alone, AlexNet+Lasso yields better outcome with regression score of 0.9643 and RMSE of 0.0023 when compared with Decision tree (RMSE of 0.0034; Regression score of 0.9578) and GRU (RMSE of 0.1253; regression score of 0.9323). When analysing the prediction of CC scores using CT scores and other baseline, laboratory and CT features, VGG-16+Linear Regression yields better results with regression score of 0.9911 and RMSE of 0.0002 when compared with Linear SVR (RMSE of 0.0006; Regression score of 0.9911) and LSTM (RMSE of 0.0005; Regression score of 0.9877). The correlation analysis is performed to identify the significance of utilizing other features in prediction of CC Score. The correlation coefficient of CT scores with actual value is 0.93 and 0.92 for Early stage group and Critical stage group respectively. The correlation coefficient of CC scores with actual value is 0.96 for Early stage group and 0.95 for Critical stage group.The classification of COVID-19 patients are carried out with the help of predicted CC Scores.

CONCLUSIONS: This proposed work is carried out in the motive of helping radiologists in faster categorization of COVID patients as Early or Severe staged using CC Scores. The automated prediction of COVID Criticality Score using our diagnostic model can help radiologists and physicians save time for carrying out further treatment and procedures.

PMID:34403841 | DOI:10.1016/j.cmpb.2021.106336

Int J Infect Dis. 2021 Aug 14:S1201-9712(21)00657-3. doi: 10.1016/j.ijid.2021.08.022. Online ahead of print.

ABSTRACT

In this single centre observational study, we demonstrated that lower cycle threshold (Ct) values (indicating higher viral loads) on admission to hospital, were associated with poorer outcomes in unvaccinated, hospitalised patients with Covid-19. We prospectively collected demographic and outcome data on all adult patients who tested positively for SARS-CoV-2 on admission to the University Hospitals North Midlands (UHNM) NHS Trust between 1^st February and 1^st July 2020. Nasopharyngeal swab samples were obtained, and a valid Ct value determined for all patients using the Public Health England (PHE) validated Viasure© reverse transcription PCR assay on admission to hospital. Multivariable logistic regression results based on data from 618 individuals demonstrated a statistically significant inverse relationship between the odds of death and Ct values (adjusted odds ratio (aOR) 0.95, 95% CI 0.92 to 0.98, p-value 0.001). The association remained highly statistically significant after adjusting for known clinical risk factors for the disease.

PMID:34403784 | DOI:10.1016/j.ijid.2021.08.022

Am J Hum Biol. 2021 Aug 17:e23648. doi: 10.1002/ajhb.23648. Online ahead of print.

ABSTRACT

OBJECTIVE: The proportion of multiple births has risen rapidly worldwide. Multiple births are likely to affect birth weight, which results in low birth weight (LBW) of less than 2500 g, possibly, because multiples are more likely to be born prematurely or less than 37 weeks into pregnancy. Using data from South Korea, this study aims to estimate the contribution of the rise in multiples to the rise in LBW incidence.

METHODS: Based on data from 2000 to 2017, we estimated the effect of multiples on LBW rates using linear regression analysis. Based on the regression analysis and the change in the proportion of multiples during this period, we calculated the contribution of the rise in multiples to the rise in LBW incidence using the total differential. In other words, we divided the change in LBW during the period due to the change in multiples by the total change during the period. The data are from the birth registry of the National Statistical Office, which contains information on the 8.4 million live births during the period 2000-2017.

RESULTS: We found that a 1 percentage point increase in multiples increases the proportion of LBWs by 0.495 percentage points. In addition, because the changes in the proportion of multiples and LBWs from 2000 to 2017 are 2.2 and 2.4 percentage points, respectively, 1.1 percentage points or 45.8% of the increase in LBWs over the period is due to the increase in multiples.

CONCLUSION: Since the Korean government introduced a measure to reduce the number of transferred embryos recently, one may expect that multiples in Korea would reduce in the near future, as it did in other countries. Subsequently, the incidence of LBW children is also likely to reduce, which is desirable in terms of the children’s health outcomes.

PMID:34403549 | DOI:10.1002/ajhb.23648

Am J Transplant. 2021 Aug 17. doi: 10.1111/ajt.16803. Online ahead of print.

ABSTRACT

Liver allocation was updated on 02/04/2020, replacing a Donor Service Area (DSA) with acuity circles (AC). The impact on waitlist outcomes for patients listed for combined liver-intestine transplantation (multivisceral transplantation [MVT]) remains unknown. The Organ Procurement and Transplantation Network/United Network for Organ Sharing database was used to identify all candidates listed for both liver and intestine between 01/01/2018 and 03/05/2021. Two eras were defined: pre-AC (2018-2020) and post-AC (2020-2021). Outcomes included 90-day waitlist mortality and transplant probability. A total of 127 adult and 104 pediatric MVT listings were identified. In adults, the 90-day waitlist mortality was not statistically significantly different, but transplant probability was lower post-AC. After risk-adjustment, post-AC was associated with a higher albeit not statistically significantly different mortality hazard (sub-distribution hazard ratio[sHR]:8.45,95%CI:0.96-74.05;p=0.054), but a significantly lower transplant probability (sHR:0.33,95%CI:0.15-0.75;p=0.008). For pediatric patients, waitlist mortality and transplant probability were similar between eras. The proportion of patients who underwent transplant with exception points was lower post-AC both in adult (44% to 9%;p=0.04) and pediatric recipients (65% to 15%;p=0.002). A lower transplant probability observed in adults listed for MVT may ultimately result in increased waitlist mortality. Efforts should be taken to ensure equitable organ allocation in this vulnerable patient population.

PMID:34403552 | DOI:10.1111/ajt.16803

Neuromodulation. 2021 Aug 17. doi: 10.1111/ner.13505. Online ahead of print.

ABSTRACT

BACKGROUND: Innovative therapeutic interventions for post-traumatic stress disorder (PTSD) are required. We opted to facilitate fear extinction by combining trauma script exposure with repetitive transcranial magnetic stimulation (rTMS) to reduce symptoms of PTSD.

OBJECTIVE: The efficacy and safety of 10 Hz rTMS of the right dorsolateral prefrontal cortex simultaneously with exposure to personal traumatic narrative were studied in patients with PTSD.

MATERIALS AND METHODS: This trial was a single-center randomized controlled trial (NCT02584894). Patients were randomly assigned 1:1 to receive eight daily sessions of 110% of motor threshold high frequency (HF) 10 Hz rTMS (110% HF rTMS) or 70% low frequency (LF) 1 Hz rTMS (70% LF rTMS) with trauma script exposure in both groups. Severity of PTSD, depression, and anxiety were assessed before and after study treatment (one month, three months) by an assessor masked to the trial group assignment. The primary outcome was the severity of PTSD assessed by the Clinician Administered PTSD Scale (CAPS). We used mixed linear regression models for statistical comparisons.

RESULTS: Thirty-eight patients (65.8% females) were randomly assigned to 110% HF rTMS (n = 18, 31.3 ± 10.0 years, 13 females) or 70% LF rTMS (n = 20, 33.5 ± 11.1 years, 12 females). From baseline to three months, mean CAPS scores decreased by 51% in the 110% HF rTMS group (from 83.7 ± 14.4 to 41.8 ± 31.9) and by 36.9% in the 70% LF rTMS group (from 81.8 ± 15.6 to 51.6 ± 23.7), but with no significant difference in improvement (time by treatment interaction -3.61 [95% confidence interval (CI), -9.70 to 2.47]; p = 0.24; effect size 0.53). One serious adverse event occurred during the study (psychogenic nonepileptic seizure).

CONCLUSION: We found no evidence of difference in clinical improvement or remission rates between the 110% HF and 70% LF stimulation. These findings may reflect the importance of exposure procedure and that larger number of participants is needed.

PMID:34403533 | DOI:10.1111/ner.13505

Int J Cosmet Sci. 2021 Aug 17. doi: 10.1111/ics.12730. Online ahead of print.

ABSTRACT

INTRODUCTION: We report on the in vitro and ex vivo effects of chiral (R)-10-hydroxystearic acid (10-HSA) compared with other mono-hydroxystearic acid regioisomers and stearic acid (SA) together with its benefit when combined with retinol.

METHODS: Following treatment with hydroxystearic acids Peroxisomal Proliferator Activated Receptor Alpha (PPARα) activity was determined in a luciferase reporter gene assay, Collagen type I was assessed in primary human dermal fibroblasts by immunohistochemistry, modification of the intracellular fibroblast collagen proteome was studied by mass-spectrometry-based proteomics and Collagen type III was assessed by immunohistochemistry on human ex vivo skin.

RESULTS: 10-HSA was the most effective PPARα agonist (15.7X induction; p<0.001), followed by 9-HSA (10.1X induction) and then 12-HSA (4.9X induction) with 17-HSA (1.7X induction) being similar to the effects of stearic acid (1.8X induction). Collagen type I levels were increased in primary human fibroblasts by 2.12X and 1.56X for 10-HSA & 9-HSA respectively in vitro with the10-HSA being significant (p<0.05): whereas 12-HSA and SA had no statistical effect over the untreated control. 10-HSA and 12-HSA modified the intracellular fibroblast collagen proteome slightly with significant increases in Collagen alpha-1 (VI) and alpha-3 (VI) proteins but only 10-HSA increased levels of Collagen alpha-2 (V), alpha-1 (III), alpha-1 (I) and alpha-2 (I) (all p<0.05) with the increases being significantly different between 10-HSA and 12-HSA for Collagen alpha-1 (I), Collagen-3 (VI) and Collagen alpha-2 (I) (p<0.01). Collagen type III in ex vivo skin was increased +47% (p<0.05) by 0.05% (1.7 mM) retinol, +70% (p<0.01) by 0.01% (0.33 mM) 10-HSA and the combination increased levels by +240% (p<0.01 for either ingredient).

CONCLUSION: Chiral (R)-10-HSA has been shown to be superior to 9, 12 & 17-HSA as a PPARα agonist. Moreover, 10-HSA stimulated collagen synthesis in monolayer fibroblast culture as assessed by proteomics and immunohistochemically. Furthermore, we also show the synergistic effects of 10-HSA with retinol on collagen III synthesis in skin explants. These results further highlight the efficacy of 10-HSA as a cosmetically-acceptable PPARα agonist and anti-aging ingredient.

PMID:34403541 | DOI:10.1111/ics.12730

Psychophysiology. 2021 Aug 17:e13918. doi: 10.1111/psyp.13918. Online ahead of print.

ABSTRACT

Aberrant effective connectivity between default mode (DMN) and salience (SAL) networks may support the tendency of depressed individuals to find it difficult to disengage from self-focused, negatively-biased thinking and may contribute to the onset and maintenance of depression. Assessment of effective connectivity, which can statistically characterize the direction of influence between regions within neural circuits, may provide new insights into the nature of DMN-SAL connectivity disruptions in depression. Functional magnetic resonance imaging (fMRI) was collected from 38 individuals with a history of major depression and 50 healthy comparison participants during completion of an emotion-word Stroop task. Activation within DMN and SAL networks and effective connectivity between DMN and SAL, assessed via Granger causality, were examined. Individuals with a history of depression exhibited greater overall network activation, greater directed connectivity from DMN to SAL, and less directed connectivity from SAL to DMN than healthy comparison participants during negative-word trials. Among individuals with a history of depression, greater DMN-to-SAL connectivity was associated with lower overall network activation and worse task performance during positive-word trials; this pattern was not observed among healthy participants. Present findings indicate that greater network activation and, specifically, influence of DMN on SAL, support negativity bias among previously depressed individuals.

PMID:34403515 | DOI:10.1111/psyp.13918