Tag: nevin manimala

Cancer Med. 2022 Mar 18. doi: 10.1002/cam4.4679. Online ahead of print.

ABSTRACT

BACKGROUND: Immune checkpoint inhibitor/tyrosine kinase inhibitor (ICI/TKI) combinations are a new standard of care for the initial treatment of metastatic renal cell carcinoma (mRCC). Their efficacy and toxicity beyond the first-line setting remain poorly defined.

METHODS: We retrospectively reviewed charts for 85 adults with mRCC of any histology receiving combination of ICI/TKI in any line of treatment at two academic centers as of 05/01/2020. We collected clinical, pathological, and treatment-related variables. Outcomes including objective response rate (ORR), progression-free survival (PFS), and toxicity were analyzed via descriptive statistics and the Kaplan-Meier method.

RESULTS: Patients received pembrolizumab, nivolumab, avelumab, or nivolumab-ipilimumab, with concurrent use of sunitinib, axitinib, pazopanib, lenvatinib, or cabozantinib. Thirty-three patients received first-line ICI/TKI therapy, while 52 received ≥ second-line ICI/TKI. The efficacy of ICI/TKI therapy decreased with increasing lines of treatment (ORR: 56.7%, 37.5%, 21.4%, and 21%; median PFS [mPFS]: 15.2, 14.2, 10.1, and 6.8 months, for first, second, third, and ≥ fourth line therapy, respectively). In the ≥ second-line setting, ICI/TKI was most useful in patients who received ICI only, with an ORR of 50% and a mPFS of 9.1 months. Efficacy was limited in patients who received both TKI and ICI previously, with an ORR of 20% and a mPFS of 5.5 months. Overall, ≥ second-line ICI/TKI was tolerable with 25 of 52 (52%) patients developing grade ≥3 adverse events.

CONCLUSIONS: ICI/TKI combination therapy is feasible and safe beyond the first-line setting. Prior treatment history appears to impact efficacy but has a lesser effect on safety/tolerability.

PMID:35304832 | DOI:10.1002/cam4.4679

J Evol Biol. 2022 Mar 18. doi: 10.1111/jeb.13998. Online ahead of print.

ABSTRACT

Assortative mating occurs when paired individuals of the same population are more similar than expected by chance. This form of non-random assortment has long been predicted to play a role in many evolutionary processes because assortatively mated individuals are assumed to be genetically similar. However, this assumption may always hold for labile traits, or traits that are measured with error. For such traits, there is a variety of proximate mechanisms that can drive phenotypic resemblance between mated partners that, notably, have very different evolutionary repercussions. Bettering our understanding of the role of assortative mating in evolution will thus require insight into its proximate causes. To date, empirical research remains sparse, especially when for labile traits. This special issue aims to stimulate such research while promoting the usage and development of statistical approaches allowing the quantification of the relative roles of alternative proximate mechanisms causing assortative mating. To this end, we first describe how the phenotypic covariance between mated partners can be usefully partitioned into components that capture one or several of five distinct mechanisms. We then demonstrate why the importance of mechanisms causing genetic covariance between the traits of partners may often be overestimated. Finally, we detail how the evolutionary causes and consequences of the diverse mechanisms may be identified.

PMID:35304800 | DOI:10.1111/jeb.13998

J Prosthodont. 2022 Mar 18. doi: 10.1111/jopr.13506. Online ahead of print.

ABSTRACT

PURPOSE: The annealing and firing cycle’s effect on the adaptation of cobalt-chromium (CoCr) restorations fabricated by additive manufacturing has been poorly documented. This study compared the marginal and internal fit of CoCr three-unit fixed dental prostheses before and after firing cycles.

MATERIAL AND METHODS: The first right maxillary premolar (MP) and molar (MM) on a typodont model, were prepared with a circumferential 1.2 mm chamfer, 2 mm occlusal reduction, and total taper of 8 degrees, to receive 3-unit fixed dental prostheses (FDP). After the framework design, 20 framework specimens were fabricated using CoCr metal powder by selective laser melting. The replica technique was used for marginal and internal fit measurements in mesiodistal and buccolingual planes. The specimens were submitted to an annealing process, and to ceramic firing protocol. Measurements were repeated after each firing cycle. The data were compared by using Levene test, t-test, and analysis of variance (ANOVA) (α = .05).

RESULTS: A significant difference was found in the total intaglio surface discrepancy between the 3 treatments. The annealing treatment induced a statistical difference in the discrepancy value compared to the as printed state (P = .028). A significant difference was detected between the initial manufacturing phase and the ceramic layering firing cycle (P = .003).

CONCLUSIONS: Firing cycles induced an alteration of the frameworks adaptation. This article is protected by copyright. All rights reserved.

PMID:35304798 | DOI:10.1111/jopr.13506

J Clin Pharm Ther. 2022 Mar 18. doi: 10.1111/jcpt.13641. Online ahead of print.

ABSTRACT

WHAT IS KNOWN AND OBJECTIVE: Premature birth affects more than 15 million infants, as well as mothers and families around the world. With the relaxation of the two-child policy, the problem of premature birth has become relatively prominent in China. According to statistics, China had a birth population of 15.23 million in 2018, with a considerably large number of premature births. This study aims to evaluate the efficacy and safety of tocolysis in the treatment of preterm delivery, provide clinical evidence for medical staff and promote the self-management of patients with premature births.

METHODS: Four English databases (PubMed, Embase, Cochrane Library and Web of Science) were retrieved by computer, the retrieval time was from the establishment of each database to November 2021, and the randomized controlled trials for the treatment of preterm delivery were screened according to the pre-set natriuretic exclusion criteria. After literature screening, data selection and risk of bias evaluation were independently conducted by two researchers. R 4.1.1 and Stata 17.0 software were used for statistical analysis.

RESULTS AND DISCUSSION: A total of 44 RCTs were included, including 6939 patients. The results of network meta-analysis reveal that in terms of effectiveness, indomethacin was the most effective intervention measure, followed by nifedipine, and the difference was statistically significant; regarding safety, nifedipine was the safest intervention measure, followed by indomethacin, and the difference was statistically significant; and in respect of adverse reactions, ritodrine had the highest probability, and the difference was statistically significant.

WHAT IS NEW AND CONCLUSION: Nifedipine may be better for delayed delivery and less likely to produce adverse pregnancy outcomes, followed by indomethacin. Limited by the number and quality of recipient studies, the aforementioned conclusions need to be verified through more high-quality studies. At the same time, the focus should be on patients with twin pregnancy and patients with clinical manifestations of extreme preterm delivery.

PMID:35304748 | DOI:10.1111/jcpt.13641

Ultraschall Med. 2022 Mar 18. doi: 10.1055/a-1778-3585. Online ahead of print.

ABSTRACT

AIM OF THE STUDY: The aim of the study is to examine the detection rates of malformations before and after the introduction of extended basic screening in Hesse by the Federal Joint Committee (Gemeinsamer Bundesausschuss, GQH) on July 1, 2013.

METHOD: This is a retrospective, mainly exploratory data analysis of quality assurance data from the Office for Quality Assurance in Hesse (GQH). The data was collected in the period from January 1, 2010 to December 31, 2016 in the obstetric departments of the Hessian hospitals using documentation forms. The classification and evaluation of the diagnoses is based on ICD-10-GM-2019.

RESULTS: At least one malformation is present in 0.7% of the cases. With a share of 30.0%, most of the congenital malformations are from the musculoskeletal system. 12.2% of the malformations come from the facial cleft, closely followed by malformations of the circulatory system with 11.3%. The highest prenatal detection rate (PDR) is found in congenital malformations of the nervous system at 56.8%. The lowest PDR is found in those of the genital organs with 2.1%. The PDR of cardiovascular malformations is 32.9%. Overall, a PDR of 25.2% is achieved. There was no change in the number of prenatal malformation diagnoses after the introduction of extended basic ultrasound. The distribution of malformation diagnoses not detected prenatally to the organ systems also has not changed after the introduction.

CONCLUSION: The introduction of extended basic ultrasound did not bring the desired improvement with regard to the PDR in Hesse. Alternative approaches should be considered.

PMID:35304733 | DOI:10.1055/a-1778-3585

Environ Sci Pollut Res Int. 2022 Mar 18. doi: 10.1007/s11356-022-19588-y. Online ahead of print.

ABSTRACT

Because of health concerns regarding the presence of enteric viruses in wastewater effluents, this study was designed to investigate the occurrence of human adenovirus (HAdV) in the irrigation water-soil-crop continuum. Viral particles were extracted from wastewater and wastewater- or water-irrigated soil and crop samples and analyzed using real-time PCR. Concentration of fecal indicator bacteria (FIB) were also determined. Quantitative microbial risk assessment was performed to determine the HAdV illness risk associated with the consumption of wastewater-irrigated vegetables. HAdV-F was detected in 74% of wastewater effluent samples with a mean concentration of 38 Genomic Copy (GC)/mL. HAdV was also detected in wastewater-irrigated soil (2 × 10² GC/g) and crop (< 10 GC/g) samples, with no statistically significant difference in concentrations between wastewater- and freshwater-irrigated samples. The results showed no correlation between concentrations of FIB and HAdV in the analyzed samples. Mean probability of illness risk from consumption of wastewater-irrigated vegetables was 4 × 10^-1 per person per year (pppy) which was about two orders of magnitude higher than the proposed value by WHO (10^-3 pppy) for safe reuse of wastewater. This finding suggests that the wastewater reuse for irrigation of vegetables eaten raw could pose a threat to human health with respect to the risk of viral illness, signifying stricter management of wastewater reuse. However, because of uncertainties in the QMRA model, particularly the ratio of infectious to non-infectious virus particles, more data is required to validate the predicted risk. This information is especially important in arid and semi-arid regions where high temperatures, UV radiation intensity, and desiccation can efficiently inactivate microorganisms in the environment.

PMID:35304720 | DOI:10.1007/s11356-022-19588-y

Eat Weight Disord. 2022 Mar 19. doi: 10.1007/s40519-022-01390-x. Online ahead of print.

ABSTRACT

PURPOSE: Various neurobiological models have utilised symptom categories to explore the underlying neural correlates in both anorexia nervosa (AN) and bulimia nervosa (BN). The aim of this research was to investigate the brain activity patterns associated with viewing food stimuli in anorexia nervosa and bulimia nervosa.

METHODS: Electronic databases including PsycInfo and PubMed were systematically searched from data base inception until 1st of December 2020, identifying 14 suitable functional magnetic resonance imaging studies (fMRI), involving 470 participants. ALE meta-analysis was used to statistically analyse the overlap of activation foci from different fMRI studies in response to visual food stimuli.

RESULTS: Comparing patients with AN with healthy control (HC), we detected hypoactivation in brain areas related to reward processing (i.e., amygdala and lentiform nucleus), and interoceptive processing (i.e., insula). In addition, patients with AN showed hyperactivations in cognitive control areas (i.e., prefrontal and anterior cingulate cortex). In contrast, patients with BN exhibited hyperactivations in brain areas related to reward processing (i.e., lentiform nucleus), and interoceptive processing (i.e., insula). Furthermore, patients with BN showed hypoactivations in brain regions associated with cognitive control (i.e., prefrontal and anterior cingulate cortex).

CONCLUSIONS: Our study shows differing neural endotypes of the two types of eating disorders, that underpin their behavioural phenotypes. While exploratory in nature, these findings might be relevant for guiding new emerging therapies, including invasive and non-invasive neuromodulation techniques in treatment of eating disorders.

LEVEL OF EVIDENCE: Level I, meta-analysis.

PMID:35304713 | DOI:10.1007/s40519-022-01390-x

Can J Anaesth. 2022 Mar 18. doi: 10.1007/s12630-022-02241-0. Online ahead of print.

ABSTRACT

PURPOSE: A multidisciplinary approach is recommended for patients with complex chronic pain (CP). Many multidisciplinary pain treatment facilities (MTPFs) use patient exclusion criteria but little is known about their characteristics. The objective of this study was to describe the frequency and characteristics of exclusion criteria in public Canadian MTPFs.

METHODS: We conducted a cross-sectional study in which we defined an MPTF as a clinic staffed with professionals from three disciplines or more (including at least one medical specialty) and whose services were integrated within the facility. We disseminated a web-based questionnaire in 2017-2018 to the administrative leads of MPTFs across the country. They were invited to complete the questionnaire about the characteristics of their facilities. Data were analyzed using descriptive statistics and correlation measures.

RESULTS: A total of 87 MTPFs were included in the analyses. Half of them (52%) reported using three exclusion criteria or more. There was no significant association between the number of exclusion criteria and wait time for a first appointment or number of new consultations in the past year. Fibromyalgia and migraine were the most frequently excluded pain syndromes (10% and 7% of MPTFs, respectively). More than one MPTF out of four excluded patients with mental health disorders (30%) and/or substance use disorders (29%), including MPTFs with specialists in their staff.

CONCLUSIONS: Multidisciplinary pain treatment facility exclusion criteria are most likely to affect CP patients living with complex pain issues and psychosocial vulnerabilities. Policy efforts are needed to support Canadian MPTFs in contributing to equitable access to pain management.

PMID:35304693 | DOI:10.1007/s12630-022-02241-0

Endocrine. 2022 Mar 19. doi: 10.1007/s12020-022-03030-x. Online ahead of print.

ABSTRACT

Obesity and overfat are most commonly assessed using the body mass index (BMI), which evaluates “total obesity”, without accounting for body fat distribution. Therefore, several indexes of obesity have been proposed, combining BMI with other measures or singular parameters. The aim of the study was to evaluate the accuracy of a new, simple index that takes into account both BMI and Waist Circumference (WC), Waist Body Mass Index (wBMI) in comparison to BMI, WC e Waist-to-Height Ratio (WHtR) for the identification of overfat and obese patients identified by fat mass percentage (FM%). 2400 non diabetic patients were enrolled. From the analysis carried out it emerges that wBMI, BMI, WC and WHtR all have a statistically significant positive correlation (p-Value < 0.001) with FM%. The multivariate analysis showed the positive relationship between these four indexes and the FM. To assess the accuracy of these indices in diagnosing the condition of overfat and obesity we used the statistical analysis Receiver Operating Characteristic (ROC). The Area Under the Curve (AUC) derived from the ROC showed that for the male gender the indicator with the greatest discriminating capacity of the conditions of overfat and obesity was the WHtR and the wBMI for the female gender. The wBMI is therefore configured as an additional tool at the disposal of the healthcare professional aimed at framing the overfat and obese patient and monitoring him during the course of treatment. Moreover wBMI is an indicator able to provide information about the FM% constituting an accurate tool for the evaluation of the overfat and obese patient.

PMID:35304685 | DOI:10.1007/s12020-022-03030-x

Neurosurg Rev. 2022 Mar 19. doi: 10.1007/s10143-022-01734-2. Online ahead of print.

ABSTRACT

Posterior communicating artery (PCoA) aneurysm is common and sometimes requires microsurgery; however, as data on premammillary artery (PMA) infarction after clipping is scarce, we retrospectively reviewed cases of post-clipping PMA infarction to analyze incidence, independent risk factors of infarction, and anatomical considerations. Data from 569 consecutive patients who underwent microsurgical clipping for unruptured PCoA aneurysm between January 2008 and December 2020 were included. Patients were categorized into the normal or the PMA infarction group. Statistical analyses and comparisons between the two groups were used to determine the influence of various factors. The normal group included 515 patients while the PMA infarction group had 31. The mean length of hospital stay was significantly longer in the PMA infarction group (10.3 ± 9.1 days) than in the normal group (6.5 ± 6.4 days; p < 0.0001). The distribution of Glasgow Outcome Scale at discharge was significantly different between the two groups (p ≤ 0.0001) but was not so at 6 months after discharge (p = 0.0568). Multivariate logistic regression analysis identified aneurysm size (odds ratio [OR], 1.194; 95% confidence interval [CI], 1.08-1.32; p = 0.0005) and medial direction of aneurysm (OR, 4.615; 95% CI, 1.224-17.406; p = 0.0239) as independent risk factors of post-clipping PMA infarction. Surgeons must beware of PMA infarction after clipping of large aneurysms that are medial in direction. Intraoperative verification of the patency of the PCoA and the PMA from various angles using various intraoperative methods can reduce morbidity due to PMA infarction.

PMID:35304692 | DOI:10.1007/s10143-022-01734-2