Tag: nevin manimala

Neonatology. 2022 Mar 2:1-8. doi: 10.1159/000522288. Online ahead of print.

ABSTRACT

BACKGROUND: Gastric transposition (GT) is a possible option for esophageal replacement in long-gap esophageal atresia (LGEA). The present study aims to report and compare indications and outcome of laparoscopic-assisted GT (LAGT) versus open (OGT) GT for LGEA repair.

METHODS: Retrospective single-center analysis of all LGEA patients undergoing GT between 2002 and 2021.

RESULTS: Thirty-one children with LGEA underwent GT. Of these, 19 underwent LAGT (mean weight at surgery 5.6 kg; mean age 167 days) and 12 underwent OGT (6.1 kg; 233 days). Indications for OGT were previous surgery (n = 7), associated severe cardiac malformations (n = 4), and a simultaneous resection of a choledochal cyst (n = 1). The conversion rate was 1. The two procedures (LAGT/OGT) differed in anesthetic time (308/350 min), duration of ventilation (5.1/5.3 days), hospital stay (34/32 days), and complications (22/15). None of the differences reached statistical significance. Outcome was also comparable: completely oral nutrition uptake in 66%/73%, slow weight gain in the low centiles in both groups, no patient developed dumping syndrome, symptomatic reflux was seen in 1 patient after OGT.

CONCLUSION: In our cohort, LAGT for repair of LGEA provided similar outcomes as open surgery. The minimally invasive approach preserves thoracal structures, prevents additional thoracotomy or laparotomy, and is faster. To realize LAGT, a postpartal treatment concept including gastrostomy placement via a microincision to minimize adhesions is essential. The open surgical approach should be considered in cases of previous extensive surgical attempts of EA correction causing severe adhesions as well as associated anomalies or genetic syndromes causing hemodynamic instability.

PMID:35235935 | DOI:10.1159/000522288

Surg Oncol. 2022 Feb 24;41:101732. doi: 10.1016/j.suronc.2022.101732. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: PET-CTs are being increasingly utilized in sarcoma care. This study sought to investigate the impact of PET-CT acquisition on time to treatment initiation.

METHODS: The records of bone and soft tissue sarcoma patients treated at our institution were reviewed. Dates of initial presentation to a sarcoma-treating physician and dates of treatment initiation were recorded.

RESULTS: Time to treatment was greater in patients (p < 0.001) with median time to treatment of 26 days (IQR 17, 36) and 20 days (IQR 12, 29) for those who did and did not undergo PET-CT, respectively. Those who underwent PET-CT in addition to a plain chest CT also had significantly increased time to treatment (p < 0.001) with median time to treatment of 27 days (IQR 17, 36) and 20 days (IQR 13, 28) for those who underwent both studies and those who underwent plain CT alone, respectively.

CONCLUSIONS: Despite a statistically significant increase in time to treatment with the acquisition of a PET-CT scan, the added time is likely clinically insignificant. Additionally, PET-CT may offer additional benefits in potentially more accurate staging.

PMID:35235893 | DOI:10.1016/j.suronc.2022.101732

Comput Methods Programs Biomed. 2022 Feb 23;218:106709. doi: 10.1016/j.cmpb.2022.106709. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVE: In this work, a mathematical model based on differential equations is proposed to describe the propagation of polio in a human population. The motivating system is a compartmental nonlinear model which is based on the use of ordinary differential equations and four compartments, namely, susceptible, exposed, infected and vaccinated individuals.

METHODS: In this manuscript, the mathematical model is extended in order to account for spatial diffusion in one dimension. Nonnegative initial conditions are used, and we impose homogeneous Neumann conditions at the boundary. We determine analytically the disease-free and the endemic equilibria of the system along with the basic reproductive number.

RESULTS: We establish thoroughly the nonnegativity and the boundedness of the solutions of this problem, and the stability analysis of the equilibrium solutions is carried out rigorously. In order to confirm the validity of these results, we propose an implicit and linear finite-difference method to approximate the solutions of the continuous model.

CONCLUSIONS: The numerical model is stable in the sense of von Neumann, it yields consistent approximations to the exact solutions of the differential problem, and that it is capable of preserving unconditionally the positivity of the approximations. For illustration purposes, we provide some computer simulations that confirm some theoretical results derived in the present manuscript.

PMID:35235894 | DOI:10.1016/j.cmpb.2022.106709

Midwifery. 2022 Feb 21;108:103290. doi: 10.1016/j.midw.2022.103290. Online ahead of print.

ABSTRACT

OBJECTIVE: Postpartum women are a vulnerable population to pandemic stressors that challenge their psychological well-being. Thus, reliable and valid instruments are necessary to measure pandemic-related stress and to identify risk and protective factors. This work aimed to assess psychometric properties of the COVID-19 Pandemic-Related Stress Scale (PSS-10-C) and associations of maternal pandemic stress with demographic, reproductive and pandemic factors of Argentinian postpartum women during the second COVID-19 wave.

DESIGN: An online cross-sectional survey was conducted from April to June 2021.

SETTING: Online recruitment of postpartum women was carried out during the second wave of COVID-19 in Argentina. This study was conducted in accordance with the Declaration of Helsinki and had the corresponding ethical approval.

PARTICIPANTS: This study was performed on 300 women, aged 18-49 years, up to 12 months postpartum in Argentina.

MEASUREMENTS AND FINDINGS: Stress was assessed with PSS-10-C, with a sociodemographic questionnaire being used to collect demographic, reproductive and pandemic variables. Statistical analysis included psychometric procedures, structural equation modeling, and multiple regressions. PSS-10-C was a reliable and structurally valid instrument with two subscales, with entire scale, Stress and Coping subscales scoring 17.31 (6.52), 9.70 (4.61) and 7.61 (2.77), respectively. History of mood disorders, pregnancy loss, and unhealthy child during the pandemic predisposed to increased stress (β > 0.10, p < 0.05), whereas having work and practicing breastfeeding promoted coping to face it (β < -0.13, p < 0.05). This situation was impaired by mood changes, loss of happiness, economic changes, fear of contracting COVID-19 -own or by a loved one- (β > 0.11, p < 0.05).

KEY CONCLUSIONS: The study highlighted the vulnerability of postpartum women’s mental health in the pandemic context, with PSS-10-C being a useful instrument for clinicians and researchers to assess perceived stress. Targeting interventions toward women at higher risk can be highly beneficial for maternal and child health.

PMID:35235890 | DOI:10.1016/j.midw.2022.103290

Complement Ther Clin Pract. 2022 Feb 23;47:101550. doi: 10.1016/j.ctcp.2022.101550. Online ahead of print.

ABSTRACT

BACKGROUND: Guizhi Gancao Longgu Muli Decoction can make a good effect on the insomnia under the catalogue of traditional Chinese medicine.

METHOD: To search the databases:Pubmed, Web of Science, EMBASE, the Cochrane Library, the China National Knowledge Infrastructure (CNKI), the China Biology Medicine disc (CBMdisc), the China Science and Technology Journal Database (VIP), the Wanfang.

RESULTS: Fifteen randomized controlled trials were included, totally including 1164 participants. After summarizing the observational index revised according to the “Guiding Principles for Clinical Research of New Chinese Medicines”, we found that the curative effect of the trial group is 2.29 times that of the control group in the fixed effect model which had a statistically significant difference [OR = 2.293681, 95%CI = 0.3266112-5.83]. And the Pittsburgh Sleep Quality Index (PSQI) which had 7 different dimensions, including subjective sleep quality[p = 0.001 < 0.05], sleep latency, sleep duration[p = 0.000 < 0.05], habitual SE[p = 0.000 < 0.05], sleep disorders[p = 0.002 < 0.05], use of sleep medications[p = 0.000 < 0.05], and daytime dysfunction[p = 0.000 < 0.05], showed a higher scores in the trial group than the one in the control group in every dimension. The final results of the total scores in PSQI also showed a higher scores in trial group with a p = 0.000 < 0.05 (Test of WMD), suggest a statistically significant difference. While the adverse effects showed a lower rate in the trial group than the one in the control group under a fixed-effect model, with a p = 0.000 < 0.05, indicate a statistically significant difference.

CONCLUSION: The efficacy and safety of GGLMD in the trial groups are better than the modern western medicine in the control groups.

PMID:35235882 | DOI:10.1016/j.ctcp.2022.101550

Psychiatry Res. 2022 Feb 17;310:114453. doi: 10.1016/j.psychres.2022.114453. Online ahead of print.

ABSTRACT

OBJECTIVES: Confirming the existence and composition of the shared genetic basis of Schizophrenia and cannabis and cigarette smoking has critical values for the clinical prevention and intervention of psychosis.

METHODS: To achieve this goal, we leveraged Genome-Wide summary statistics of Schizophrenia (n = 99,934), cigarette smoking (n = 518,633) and cannabis usage (n = 162,082). We applied Causal Analysis Using Summary Effect Estimates (CAUSE) and genomic structural equation modeling (GenomicSEM) to quantify the contribution of a common genetic factor of cannabis and cigarette smoking and schizophrenia (referred to as SCZ_SMO), then identified genome-wide loci that made up SCZ_SMO.

RESULTS: We estimated that SCZ_SMO explained 8.6% of Schizophrenia heritability (Z score <-2.5 in CAUSE, p<10^-20 in Genomic SEM). There were 20 independent loci showing association with SCZ_SMO at the genome-wide threshold of p<5 × 10^-8. At the top locus on chromosome 11, fine-mapping identified rs7945073 (posterior inclusion probability =0.12, p = 2.24 × 10^-32) as the top risk variants. Gene-level association and fine-mapping highlighted NCAM1, PHC2, and SEMA6D as risk genes of SCZ_SMO. Other risk genes were enriched in cortex, neuron, and dendritic spines (adjusted p<0.05). SCZ_SMO showed significant positive correlation (p<10^-6) with the genetic risk of attention deficit hyperactivity disorder (r = 0.50), lifestyle problems (r = 0.83), social deprivation (r = 0.58) and all-cause pregnant loss (r = 0.60).

CONCLUSION: Our result provided new evidence on the shared genetic basis model for the association between Schizophrenia and smoking and provided genetic and biological insights into their shared mechanism.

PMID:35235886 | DOI:10.1016/j.psychres.2022.114453

Eur J Cancer. 2022 Feb 27;165:136-145. doi: 10.1016/j.ejca.2022.01.023. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with cancer-associated venous thromboembolism (VTE) have a high risk of VTE recurrence and anticoagulant treatment-related bleeding, but the correlation of these risks with the cancer stage is unclear.

METHODS: We evaluated the risks of VTE recurrence and treatment-related major bleeding according to the cancer stage in patients with VTE and solid cancer randomised to apixaban or dalteparin in the Caravaggio study. Cancer stage was categorised by expert cancer physicians according to pre-specified criteria, and study outcomes were adjudicated by an independent committee unaware of cancer stage and treatment allocation.

RESULTS: Of the 1034 patients included in this analysis, 217 (21.0%) had localised cancer, 279 (27.0%) locally advanced cancer and 503 (48.7%) metastatic cancer. Cancer stage was undetermined in 35 patients (3.4%). VTE recurrence and major bleeding rates were 2.8% and 3.2% in patients with localised cancer, respectively. In comparison to patients with localised cancer, the VTE recurrence rate was higher in patients with locally advanced cancer (7.5%, hazard ratio [HR] = 2.8, 95% confidence interval [CI] = 1.1-6.9) and metastatic cancer (8.7%, HR = 3.3, CI = 1.4-7.7, CI). Patients with metastatic cancer had numerically increased major bleedings compared to those with localised cancer (5.2%, HR = 1.65, CI = 0.7-3.8). The efficacy and safety of apixaban and dalteparin across patients with different cancer stages were consistent with the findings observed in the overall patients with cancer randomised in the study.

CONCLUSIONS: Patients with locally advanced and metastatic cancer have a higher rate of VTE recurrence than patients with localised cancer with no statistically significant difference in treatment-related major bleeding.

PMID:35235870 | DOI:10.1016/j.ejca.2022.01.023

J Pain Symptom Manage. 2022 Feb 27:S0885-3924(22)00416-X. doi: 10.1016/j.jpainsymman.2022.02.334. Online ahead of print.

ABSTRACT

CONTEXT: Most patient-reported outcomes (PRO) are not directly tailored to an individual patient’s values, partially because tailored PROs require clinical interviews or are difficult to use in statistical analyses.

OBJECTIVES: This study tested a method for tailoring pain PROs, Precision PROs, that can be implemented and analyzed using standard statistical tests.

METHODS: People with cancer and pain (n=231) completed an online survey and then a second survey (n=161) one to two weeks later. Participants reviewed the PROMIS pain interference item bank, chose the four items most important to their quality of life and then completed those items. Kappas compared choices between the two surveys. Participants completed measures of pain intensity, physical function, and a standard pain interference measure.

RESULTS: All participants were able to select four items that were personally meaningful. Only one item (enjoyment of life) was chosen by more than half the sample (50.6%). Kappas for item choice were in the moderate to nearly perfect range for 32 of 35 items. The majority of the sample (59%) preferred tailoring their own PRO questions to completing a previously determined, non-patient-specific PRO. The Precision PRO scores had similar associations with pain intensity and physical function as the standard pain interference measure.

CONCLUSIONS: The Precision PRO approach was feasible, more preferred by patients, and showed consistency over a short timeframe. This approach could be used to make PRO assessment in clinical care and clinical trials more patient-centered. Additional research is needed to determine the generalizability of this approach to other outcomes and populations.

PMID:35235855 | DOI:10.1016/j.jpainsymman.2022.02.334

Eur J Cancer. 2022 Feb 27;165:125-135. doi: 10.1016/j.ejca.2022.01.039. Online ahead of print.

ABSTRACT

AIM: This study aims to assess the quality of life and quality of care as experienced by patients with advanced cancer and their relatives while taking their interdependency into account.

METHODS: A prospective multicentre observational study (eQuiPe study) was conducted. Quality of life scores (EORTC QLQ-C30) was compared to a matched normative population and logistic regression analyses were conducted to assess the relation between high emotional functioning (EF, measured with the EORTC QLQ-C30) and experienced quality of care (IN-PATSAT32, CQ-index PC).

RESULTS: In total, 1103 (65%) patients and 831 (71%) relatives completed the baseline questionnaire, including 699 unique patient-relative couples. Patients experienced lower EF than the normative population (78 versus 87, p < .001). Compared to patients, relatives reported clinically relevantly lower EF (69 versus 78, p < .001). Being more satisfied with care in general (p < .05) and clarity about the key health-care provider (p < .05) was positively associated with high EF in patients. For relatives, experienced continuity of care (p < .01) and information for the patient (p < .05) were positively associated with high EF. The EF of patients (p < .001) and relatives (p < .001) were positively associated with each other and continuity of care as perceived by relatives was positively associated with high EF in patients (p < .01).

CONCLUSIONS: Patients with advanced cancer reported low levels of EF but their relatives reported even lower levels of EF. Experienced integrated organisation and satisfaction with care were positively related to EF. The interdependent relation between patients’ and relatives’ EF and their care experiences suggests that a family-centred approach can optimise palliative cancer care.

TRIAL REGISTRATION: The eQuiPe study is registered as NTR6584 in the Netherlands Trial Register.

PMID:35235869 | DOI:10.1016/j.ejca.2022.01.039

Cell Rep. 2022 Mar 1;38(9):110444. doi: 10.1016/j.celrep.2022.110444.

ABSTRACT

Accumulation of senescent cells affects organismal aging and the prevalence of age-associated disease. Emerging evidence suggests that activation of autophagy protects against age-associated diseases and promotes longevity, but the roles and regulatory mechanisms of autophagy in cellular senescence are not well understood. Here, we identify the transcription factor, MondoA, as a regulator of cellular senescence, autophagy, and mitochondrial homeostasis. MondoA protects against cellular senescence by activating autophagy partly through the suppression of an autophagy-negative regulator, Rubicon. In addition, we identify peroxiredoxin 3 (Prdx3) as another downstream regulator of MondoA essential for mitochondrial homeostasis and autophagy. Rubicon and Prdx3 work independently to regulate senescence. Furthermore, we find that MondoA knockout mice have exacerbated senescence during ischemic acute kidney injury (AKI), and a decrease of MondoA in the nucleus is correlated with human aging and ischemic AKI. Our results suggest that decline of MondoA worsens senescence and age-associated disease.

PMID:35235784 | DOI:10.1016/j.celrep.2022.110444