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Nevin Manimala Statistics

Physiological tracer distribution and benign lesion incidental uptake of Al18F-NOTA-FAPI-04 on PET/CT imaging

Nucl Med Commun. 2022 May 4. doi: 10.1097/MNM.0000000000001563. Online ahead of print.

ABSTRACT

OBJECTIVE: To systematically investigate the physiological distribution and benign lesion incidental uptake of Al18F-NOTA-FAPI-04 (18F-FAPI) in cancer patients to establish the normal uptake range in relevant organs and lesions.

METHODS: Twenty patients who underwent 18F-FAPI PET/CT imaging were retrospectively assessed. Organ and benign lesion tracer uptake was quantified based on standardized uptake values (SUVmax and SUVmean). We compared the variation in tracer uptake in certain organs between men and women, analyzed the possible reasons for diffuse uptake in the thyroid, and assessed tracer uptake variations in the uterus in different menstrual cycle phases. Incidental tracer uptake in benign lesions was also assessed.

RESULTS: Physiological 18F-FAPI uptake was observed in the urinary tract, biliary tract system, submandibular glands, pancreas, thyroid, uterus, intestine, prostate gland, parotid gland, myocardium, kidney cortex, and muscles, but not the brain, lungs, liver, spleen, colon, and breasts. The SUVmean for each organ was similar for women and men (all P > 0.05). Diffuse tracer uptake in the thyroid was caused by normal thyroid or thyroiditis; there were no statistically significant differences between them (SUVmax: t = -1.3, P = 0.25; SUVmean: t = -1.1, P = 0.31). There was a significant difference for uterus uptake among different menstrual cycle phases (SUVmax: F = 5.08, P = 0.04; SUVmean: F = 5.19, P = 0.04). Incidental benign lesion tracer uptake was observed in patients with esophagitis, thyroiditis, arthritis, fractures, and uterine fibroids.

CONCLUSION: This study provides a reference range for 18F-FAPI uptake in relevant organs and benign lesions. Benign lesion 18F-FAPI uptake may reduce 18F-FAPI PET/CT specificity.

PMID:35506283 | DOI:10.1097/MNM.0000000000001563

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The Association of Prediagnostic Statin Use with Aggressive Prostate Cancer from the Multiethnic Cohort Study

Cancer Epidemiol Biomarkers Prev. 2022 May 4;31(5):999-1005. doi: 10.1158/1055-9965.EPI-21-1165.

ABSTRACT

BACKGROUND: There is a growing body of evidence supporting the protective effect of statins on the risk of prostate cancer, in particular aggressive disease. Past research has mostly been conducted in North American cohorts of White men.

METHODS: In the multiethnic cohort (MEC), we investigated the association of prediagnostic statin use with the incidence and mortality of prostate cancer across five racial/ethnic groups (White, African American, Japanese American, Latino, and Native Hawaiian).

RESULTS: Among 31,062 male participants who completed a detailed medication questionnaire, 31.4% reported use of statins, 2,748 developed prostate cancer, and 261 died from the disease. After adjusting for potential confounders, prediagnostic statin use was associated with a 32% lower risk of fatal prostate cancer [95% confidence interval (CI) = 0.50-0.91], with the inverse association suggested consistently across the five racial/ethnic groups. Moreover, an 11% lower risk of aggressive prostate cancer (95% CI = 0.76-1.03) was observed in statin users than in nonusers. We found no statistically significant association between prediagnostic statin use and total prostate cancer or nonaggressive disease. Prediagnostic statin use was suggestively associated with a 19% reduction in prostate cancer-specific mortality (95% CI = 0.59-1.10) and an 8% reduction in all-cause mortality (95% CI = 0.79-1.07).

CONCLUSIONS: In the MEC, prediagnostic use of statin was associated with lower risks of aggressive forms of prostate cancer.

IMPACT: Our findings provide further support for the potential benefits of statins in reducing the risk and mortality of prostate cancer, especially aggressive disease.

PMID:35506249 | DOI:10.1158/1055-9965.EPI-21-1165

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Validation of host cerebrospinal fluid protein biomarkers for early diagnosis of tuberculous meningitis in children: a replication and new biosignature discovery study

Biomarkers. 2022 May 4:1-29. doi: 10.1080/1354750X.2022.2071991. Online ahead of print.

ABSTRACT

The diagnosis of tuberculous meningitis (TBM) in children is often delayed due to diagnostic difficulties. New tools are urgently needed to improve the diagnosis of the disease in this vulnerable group. The present study aimed to validate the accuracy of recently identified host cerebrospinal (CSF) biomarkers as candidates for the diagnosis of TBM in children. We collected CSF samples from 87 children aged 3 months to 13 years, that were consecutively admitted at a tertiary hospital in Cape Town, South Africa, on suspicion of having TBM. We evaluated the concentrations of 67 selected host protein biomarkers using a multiplex platform. Previously identified 3-marker (VEGF-A + IFN-γ + MPO) and 4-marker (IFN-γ + MPO + ICAM-1 + IL-8) signatures diagnosed TBM with AUCs of 0.89 (95% CI, 0.81-0.97) and 0.87 (95% CI, 0.79-0.95) respectively; sensitivities of 80.6% (95% CI, 62.5-92.5%) and 81.6% (95% CI, 65.7-92.3%), and specificities of 86.8% (71.9-95.6%) and 83.7% (70.4-92.7%) respectively. Furthermore, a new combination between the analytes (CC4b + CC4 + procalcitonin + CCL1) showed promise, with an AUC of 0.98 (95% CI, 0.94-1.00). We have shown that the accuracies of previously identified candidate CSF biomarkers for childhood TBM was reproducible. Our findings augur well for the future development of a simple bedside test for the rapid diagnosis of TBM in children.

PMID:35506251 | DOI:10.1080/1354750X.2022.2071991

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Nevin Manimala Statistics

Are Programmed cell death protein-1 and Angiopoietins-2 effective biomarkers for detection the severity of psoriatic patients?

J Cosmet Dermatol. 2022 May 4. doi: 10.1111/jocd.15039. Online ahead of print.

ABSTRACT

BACKGROUND: Early detection of psoriasis is still an open discussion. Psoriatic lesions are characterized by red/scaly plaques affecting different body-sites.

OBJECTIVES: To evaluate the levels of Programmed cell death protein-1(PD-1) and Angiopoietins-2(Ang-2) in serum,lesional and perilesional of psoriatic patients and correlating them with controls and disease severity.

SUBJECTS AND METHODS: Serum samples were obtained from 40 participants subdivided equally into psoriatic and healthy controls, 4mm punch_biopsy equally from lesional and perilesional skin of individuals. PD-1/ANG-2 ELISA kits were used for determining the serum and tissue levels among groups.

RESULTS: Serum and tissue levels of PD-1 and Ang-2 were overexpressed in psoriatic patients compared to controls. There was a statistical difference between patients and controls in level of PD-1(serum and tissue) with p-value 0.006 and 0.0001 respectively. There was a statistical difference between both groups for ANG-2(serum and tissue) with p-value 0.03 and 0.0001 respectively. There were positive correlations between PASI score and PD-1 in tissue (r=0.467, p=0.038). Also, positive correlation between the level of PD-1 in serum and tissue (r=0.369,p=0.019), the serum levels of PD-1 and ANG-2 (r=0.78,p>0.0001), PD-1 and Ang-2 in tissue (r=0.583,p=0.0001) were detected.

CONCLUSION: PD-1 and ANG-2 can be highly recommended to determine the severity of psoriasis.

PMID:35506216 | DOI:10.1111/jocd.15039

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Nevin Manimala Statistics

Face masking and COVID-19: potential effects of variolation on transmission dynamics

J R Soc Interface. 2022 May;19(190):20210781. doi: 10.1098/rsif.2021.0781. Epub 2022 May 4.

ABSTRACT

Face masks do not completely prevent transmission of respiratory infections, but masked individuals are likely to inhale fewer infectious particles. If smaller infectious doses tend to yield milder infections, yet ultimately induce similar levels of immunity, then masking could reduce the prevalence of severe disease even if the total number of infections is unaffected. It has been suggested that this effect of masking is analogous to the pre-vaccination practice of variolation for smallpox, whereby susceptible individuals were intentionally infected with small doses of live virus (and often acquired immunity without severe disease). We present a simple epidemiological model in which mask-induced variolation causes milder infections, potentially with lower transmission rate and/or different duration. We derive relationships between the effectiveness of mask-induced variolation and important epidemiological metrics (the basic reproduction number and initial epidemic growth rate, and the peak prevalence, attack rate and equilibrium prevalence of severe infections). We illustrate our results using parameter estimates for the original SARS-CoV-2 wild-type virus, as well as the Alpha, Delta and Omicron variants. Our results suggest that if variolation is a genuine side-effect of masking, then the importance of face masks as a tool for reducing healthcare burdens from COVID-19 may be under-appreciated.

PMID:35506215 | DOI:10.1098/rsif.2021.0781

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A probabilistic framework for windows of opportunity: the role of temporal variability in critical transitions

J R Soc Interface. 2022 May;19(190):20220041. doi: 10.1098/rsif.2022.0041. Epub 2022 May 4.

ABSTRACT

The establishment of young organisms in harsh environments often requires a window of opportunity (WoO). That is, a short time window in which environmental conditions drop long enough below the hostile average level, giving the organism time to develop tolerance and transition into stable existence. It has been suggested that this kind of establishment dynamics is a noise-induced transition between two alternate states. Understanding how temporal variability (i.e. noise) in environmental conditions affects establishment of organisms is therefore key, yet not well understood or included explicitly in the WoO framework. In this paper, we develop a coherent theoretical framework for understanding when the WoO open or close based on simple dichotomous environmental variation. We reveal that understanding of the intrinsic timescales of both the developing organism and the environment is fundamental to predict if organisms can or cannot establish. These insights have allowed us to develop statistical laws for predicting establishment probabilities based on the period and variance of the fluctuations in naturally variable environments. Based on this framework, we now get a clear understanding of how changes in the timing and magnitude of climate variability or management can mediate establishment chances.

PMID:35506213 | DOI:10.1098/rsif.2022.0041

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Nevin Manimala Statistics

Patient safety in home care: A multicenter cross-sectional study about medication errors and medication management of nurses

Pharmacol Res Perspect. 2022 Jun;10(3):e00953. doi: 10.1002/prp2.953.

ABSTRACT

Studies assume that up to 30% of home care recipients are exposed to a possible medication error. For the home care sector, the study situation regarding such errors is limited. The aim of the study was to find out how often medication errors occur and whether they are related to training, quality assurance measures (use of the double-check principle (DCP)), and other structural conditions of home care services. A cross-sectional study was conducted, comprising 485 fully trained nurses of 107 randomly selected home care services. Potential influencing factors were analyzed in a multiple logistic regression model. Of 485 fully qualified nurses, 41.6% reported medication errors within a 12-month period, while 14.8% did not answer this question. Nurses who had attended medication training within the last 2 years compared to a longer period (frequently to rather rarely applied DCP); the odds ratio of not making medication-related errors was 1.79[1.42-3.09] (OR 3.13; [1.88-5.20]). Years of professional experience, amount of patients per shift, and type of work contract (full/part-time) were not statistically significantly associated with reported medication errors. Medication-related errors occur frequently in home care. Regular training and adequate quality management measures increase patient safety. Nursing managers and other responsible individuals of home care institutions have to make sure that nursing staff take part in regular medication training and apply the DCP when they give out medication in home care.

PMID:35506209 | DOI:10.1002/prp2.953

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Nevin Manimala Statistics

Non-genetic risk factors for keratoconus

Clin Exp Optom. 2022 May 3:1-11. doi: 10.1080/08164622.2022.2062222. Online ahead of print.

ABSTRACT

Keratoconus is a complex and multifactorial disease and its exact aetiology remains unknown. This current study examined the important environmental risk factors and their association with keratoconus. This study was registered in the PROSPERO International Prospective Register of systematic reviews under registration number CRD42021256792 in 2021. Scopus, Web of Science, PubMed, and Cochrane CENTRAL databases were searched for all relevant articles published from 1 January 1900 to 31 July 2021. National Institutes of Health Quality Assessment Tool was used to assess the methodological quality of the studies. The assessment for statistical heterogeneity was assessed using the Z-statistics on RevMan v5.4. P-value of <0.05 was considered as statistically significant and I2 < 25% as homogenous. Thirty studies were included in this meta-analysis. Pooled odds ratio was calculated with 95% CI. The pooled odds ratio (OR) of eye rubbing, atopy, asthma, and eczema was 3.64 (95% CI, 2.02, 6.57), 1.90 (95% CI, 1.22, 2.94), 1.36 (95% CI, 1.15, 1.61) and 1.90 (95% CI, 1.22, 2.94), respectively. The OR for diabetes was 0.86 (95% CI 0.73, 1.02), and use of sunglasses, contact lens, allergic conjunctivitis, side sleep position and prone sleep position was 0.40 (95% CI, 0.16, 0.99), 1.68 (0.70, 4.00), 2.24 (95% CI, 0.68, 7.36), 3.81 (95% CI, 0.31, 46.23), 12.76 (95% CI, 0.27, 598.58), respectively. Twenty studies were considered to be of high quality, nine to be moderate and one to be low. Environmental risk factors have been identified to play a role in the susceptibility of keratoconus. However, further large-scale longitudinal studies are needed to understand the mechanisms between environmental risk factors and keratoconus.

PMID:35504720 | DOI:10.1080/08164622.2022.2062222

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Nevin Manimala Statistics

Uptake and impact of the English National Health Service digital diabetes prevention programme: observational study

BMJ Open Diabetes Res Care. 2022 May;10(3):e002736. doi: 10.1136/bmjdrc-2021-002736.

ABSTRACT

INTRODUCTION: ‘Healthier You’, the National Health Service (NHS) diabetes prevention programme (DPP) offers adults in England at high risk of type 2 diabetes (T2DM) an evidence-based behavioral intervention to prevent or delay T2DM onset. This study assesses the impact of a pilot digital stream of the DPP (DDPP) on glycated hemoglobin (HbA1c) and weight.

RESEARCH DESIGN AND METHODS: A service evaluation employing prospectively collected data in a prospective cohort design in nine NHS local pilot areas across England. Participants were adults with non-diabetic hyperglycemia (NDH) (HbA1c 42-47 mmol/mol or fasting plasma glucose 5.5-6.9 mmol/L) in the 12 months prior to referral. The DDPP comprised five digital health interventions (DHI). Joint primary outcomes were changes in HbA1c and weight between baseline and 12 months. HbA1c and weight readings were recorded at referral (baseline) by general practices, and then at 12-month postregistration. Demographic data and service variables were collected from the DHI providers.

RESULTS: 3623 participants with NDH registered for the DDPP and of these, 2734 (75%) were eligible for inclusion in the analyses. Final (12-month) follow-up data for HbA1c were available for 1799 (50%) and for weight 1817 (50%) of registered participants. Mean change at 12 months was -3.1 (-3.4 to -2.8) kg, p<0.001 for weight and -1.6 (-1.8 to -1.4) mmol/mol, p<0.001 for HbA1c. Access to peer support and a website and telephone service was associated with significantly greater reductions in HbA1c and weight.

CONCLUSIONS: Participation in the DDPP was associated with clinically significant reductions in weight and HbA1c. Digital diabetes prevention can be an effective and wide-reaching component of a population-based approach to addressing type 2 diabetes prevention.

PMID:35504697 | DOI:10.1136/bmjdrc-2021-002736

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Trends in glycemic control in patients with insulin therapy compared with non-insulin or no drugs in type 2 diabetes in Japan: a long-term view of real-world treatment between 2002 and 2018 (JDDM 66)

BMJ Open Diabetes Res Care. 2022 May;10(3):e002727. doi: 10.1136/bmjdrc-2021-002727.

ABSTRACT

INTRODUCTION: We investigated trends in the proportion of diabetes treatment and glycemic control, which may be altered by recent advances in insulin and non-insulin drugs, in Japanese patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS: A serial cross-sectional study was performed using a multicenter large-population database from the Japan Diabetes Clinical Data Management study group. Patients with type 2 diabetes who attended clinics belonging to the study group between 2002 and 2018 were included to examine trends in glycated hemoglobin A1c (HbA1c) by treatment group using multivariable non-linear regression model.

RESULTS: The proportion of patients with insulin only decreased from 15.0% to 3.6%, patients with insulin+non-insulin drugs increased from 8.1% to 15.1%, patients with non-insulin drugs increased from 50.8% to 67.0%, and those with no drugs decreased from 26.1% to 14.4% from 2002 to 2018, respectively. The HbA1c levels of each group, except for no drugs, continued to decrease until 2014 (unadjusted mean HbA1c (%) from 2002 to 2014: from 7.89 to 7.45 for insulin only, from 8.09 to 7.63 for insulin+non-insulin, and from 7.51 to 6.98 for non-insulin) and remained unchanged thereafter. Among insulin-treated patients, use of human insulin decreased, use of long-acting analog insulin increased, and concomitant use of non-insulin drugs increased (from 35.1% in 2002 to 80.9% in 2018), which included increased use of dipeptidyl peptidase 4 inhibitors, sodium-glucose cotransporter 2 inhibitors, and glucagon-like peptide 1 receptor agonists, and the persistently high use of metformin.

CONCLUSIONS: During the past two decades, combined use of insulin and non-insulin drugs increased and glycemic control improved and leveled off after 2014 in Japanese patients with type 2 diabetes. Further studies of the trend in association with age and factors related to metabolic syndrome are necessary to investigate strategies aiming at personalized medicine in diabetes care.

PMID:35504696 | DOI:10.1136/bmjdrc-2021-002727