Tag: nevin manimala

JCO Glob Oncol. 2022 May;8:e2100372. doi: 10.1200/GO.21.00372.

ABSTRACT

PURPOSE: The incidence of cancer in sub-Saharan Africa is increasing rapidly, yet cancer research in the region continues to lag. One contributing factor is limited exposure to clinical research among trainees. We describe implementation and results of a virtual clinical research training program for Zambian clinical oncology fellows developed jointly by the Cancer Diseases Hospital in Zambia and the MD Anderson Cancer Center to address this need.

METHODS: The clinical research training program consisted of 14 weekly virtual lectures, development of research questions by Zambian clinical oncology fellows, assignment of faculty and peer mentors, longitudinal mentorship of research protocols, and anonymous precourse and postcourse surveys. The paired t-test was used to analyze the change in academic self-efficacy scores.

RESULTS: Fourteen Zambian clinical oncology fellows participated. Senior fellows were paired with research mentors, leading to the development of eight research protocols. A total of 70 meetings and 126 hours of mentorship occurred with a median of seven meetings and 15 hours per pairing. The precourse and postcourse survey response rates were 86% and 79%, respectively. There were statistically significant increases in nine of 12 academic self-efficacy domains. The largest gains were in ability to independently perform research (P < .001) and research mentorship (P = .02) with an average increase of 1.5 points on a five-point scale in both domains.

CONCLUSION: The Cancer Diseases Hospital MD Anderson Cancer Center clinical research training program for Zambian clinical oncology fellows led to increases in multiple academic self-efficacy domains among participants, formation of longitudinal mentorship groups with both faculty and peer mentors, and development of Zambian-led research protocols, demonstrating the feasibility of implementing a virtual model. This may be especially relevant because of shifting international collaboration paradigms after the COVID-19 pandemic.

PMID:35594499 | DOI:10.1200/GO.21.00372

Biol Reprod. 2022 May 19:ioac105. doi: 10.1093/biolre/ioac105. Online ahead of print.

ABSTRACT

In the recent years a special attention has been given to a major health concern namely to male infertility, defined as the inability to conceive after 12 months of regular unprotected sexual intercourse, taken into account the statistics that highlight that sperm counts have dropped by 50-60% in recent decades. According to the WHO, infertility affects approximately 9% of couples globally, and the male factor is believed to be present in roughly 50% of cases, with exclusive responsibility in 30%. The aim of this manuscript is to present an evidence-based approach for diagnosing male infertility that includes finding new solutions for diagnosis and critical outcomes, retrieving up-to-date studies and existing guidelines. The diverse factors that induce male infertility generated in a vast amount of data that needed to be analysed by a clinician before a decision could be made for each individual. Modern medicine faces numerous obstacles as a result of the massive amount of data generated by the molecular biology discipline. To address complex clinical problems, vast data must be collected, analysed, and used, which can be very challenging. The use of artificial intelligence (AI) methods to create a decision support system can help predict the diagnosis and guide treatment for infertile men, based on analysis of different data as environmental and lifestyle, clinical (sperm count, morphology, hormone testing, karyotype, etc.) and “omics” bigdata. Ultimately, the development of AI algorithms will assist clinicians in formulating diagnosis, making treatment decisions, and predicting outcomes for assisted reproduction techniques.

PMID:35594455 | DOI:10.1093/biolre/ioac105

Neuroreport. 2022 Jun 8;33(9):392-398. doi: 10.1097/WNR.0000000000001796. Epub 2022 May 11.

ABSTRACT

OBJECTIVES: Central nervous system effects of lingual strengthening exercise to treat dysphagia remain largely unknown. This pilot study measured changes in microstructural white matter to capture alterations in neural signal processing following lingual strengthening exercise.

METHODS: Diffusion-weighted images were acquired from seven participants with dysphagia of varying etiologies, before and after lingual strengthening exercise (20 reps, 3×/day, 3 days/week, 8 weeks), using a 10-min diffusion sequence (9 b0, 56 directions with b1000) on GE750 3T scanner. Tract-Based Spatial Statistics evaluated voxel-based group differences for fractional anisotropy, mean diffusivity, axial diffusivity, radial diffusivity and local diffusion homogeneity (LDH). Paired t-tests evaluated treatment differences on each metric (P < 0.05).

RESULTS: After lingual strengthening exercise, lingual pressure generation increased (avg increase = 46.1 hPa; nonsignificant P = 0.52) with these changes in imaging metrics: (1) decrease in fractional anisotropy, forceps minor; (2) increase in mean diffusivity, right inferior fronto-occipital fasciculus (IFOF); (3) decrease in mean diffusivity, left uncinate fasciculus; (4) decrease in axial diffusivity, both left IFOF and left uncinate fasciculus; (5) increase in LDH, right anterior thalamic radiation and (6) decrease in LDH, temporal portion of right superior longitudinal fasciculus. There was a positive correlation between diffusion tensor imaging metrics and change in lingual pressure generation in left IFOF and the temporal portion of right superior longitudinal fasciculus.

CONCLUSIONS: These findings suggest that lingual strengthening exercise can induce changes in white matter structural and functional properties in a small group of patients with dysphagia of heterogeneous etiologies. These procedures should be repeated with a larger group of patients to improve interpretation of overall lingual strengthening exercise effects on cortical structure and function.

PMID:35594433 | DOI:10.1097/WNR.0000000000001796

Am J Phys Med Rehabil. 2022 Jun 1;101(6):575-580. doi: 10.1097/PHM.0000000000001824.

ABSTRACT

The development of high-quality research is desired in all healthcare fields. Experimental and nonexperimental designs are used to investigate the effect or association of an intervention and clinical or surrogate outcome. The aims of these methods are to improve knowledge and to develop new strategies to manage a disease or condition. Randomized clinical trials are considered one of the standard methods to test the efficacy of a new drug or intervention; however, they are costly, have reduced generalizability, and cannot be feasible in all scenarios. Well-designed observational studies can provide valuable information regarding exposure factor and the event under investigation. In physical and rehabilitation medicine, where complex procedures and multiple risk factors can be involved in the same disease, the use of observational study must be planned in detail and a priori to avoid overestimations. In this article, we will give an overview of the methods used for observational design studies in physical and rehabilitation medicine using clinical examples to illustrate each method. We will describe when it is appropriate and how to use the observational studies in different scenarios explaining how to deal with potential bias and confounders using the adequate design and statistical plan for the situation.

PMID:35594408 | DOI:10.1097/PHM.0000000000001824

Proc Natl Acad Sci U S A. 2022 May 24;119(21):e2119765119. doi: 10.1073/pnas.2119765119. Epub 2022 May 20.

ABSTRACT

SignificanceQuantum coherence has a fundamentally different origin for nonidentical and identical particles since for the latter a unique contribution exists due to indistinguishability. Here we experimentally show how to exploit, in a controllable fashion, the contribution to quantum coherence stemming from spatial indistinguishability. Our experiment also directly proves, on the same footing, the different role of particle statistics (bosons or fermions) in supplying coherence-enabled advantage for quantum metrology. Ultimately, our results provide insights toward viable quantum-enhanced technologies based on tunable indistinguishability of identical building blocks.

PMID:35594392 | DOI:10.1073/pnas.2119765119

Am J Phys Med Rehabil. 2022 Jun 1;101(6):561-568. doi: 10.1097/PHM.0000000000001867. Epub 2021 Sep 30.

ABSTRACT

BACKGROUND: The robotic assisted transfer device was developed as an updated lift technology to reduce adjustments in posture while increasing capabilities offered by transfer devices. The purpose of this study was to compare the trunk biomechanics of a robotic assisted transfer device and a mechanical floor lift in the transfer of a care recipient by a caregiver during essential transfer tasks.

METHODS: Investigators enrolled 28 caregiver/care recipient dyads to complete 36 transferring tasks. Surface electromyography for the back muscles and motion data for trunk range of motion were collected for selected surfaces, phase, and direction tasks using a robotic assisted transfer device and a mechanical floor lift.

RESULTS: Robotic assisted transfer device transfers required significantly smaller range of trunk flexion (P < 0.001), lateral bend (P < 0.001), and axial rotation (P = 0.01), in addition to smaller distance covered (P < 0.001), average instantaneous velocity (P = 0.01), and acceleration (P < 0.001) compared with a mobile floor lift. The robotic assisted transfer device transfers required significantly smaller peak erector spinae (left: P = 0.001; right: P < 0.001) and latissimus dorsi (right: P < 0.001) and integrated erector spinae left (P = 0.001) and latissimus dorsi right (P = 0.01) electromyography signals compared with the floor lift.

CONCLUSIONS: The robotic assisted transfer device provides additional benefits to mobile floor lifts which, coupled with statistically lower flexion, extension, and rotation, may make them an appealing alternative intervention.

PMID:35594407 | DOI:10.1097/PHM.0000000000001867

J Biopharm Stat. 2022 May 20:1-19. doi: 10.1080/10543406.2022.2058526. Online ahead of print.

ABSTRACT

Multiple phase I clinical trials may be performed to determine specific maximum tolerated doses (MTD) for specific races or cancer types. In these situations, borrowing historical information has potential to improve the accuracy of estimating toxicity rate and increase the probability of correctly targeting MTD. To utilize historical information in phase I clinical trials, we proposed using the Meta-Analytic-Predictive (MAP) priors to automatically estimate the heterogeneity between historical trials and give a relatively reasonable amount of borrowed information. We then applied MAP priors in some famous phase I trial designs, such as the continual reassessment method (CRM), Keyboard design and Bayesian optimal interval design (BOIN), to accomplish the process of dose finding. A clinical trial example and extended simulation studies show that our proposed methods have robust and efficient statistical performance, compared with those designs which do not consider borrowing information.

PMID:35594366 | DOI:10.1080/10543406.2022.2058526

PLoS One. 2022 May 20;17(5):e0268181. doi: 10.1371/journal.pone.0268181. eCollection 2022.

ABSTRACT

Invariants for complicated objects such as those arising in phylogenetics, whether they are invariants as matrices, polynomials, or other mathematical structures, are important tools for distinguishing and working with such objects. In this paper, we generalize a complete polynomial invariant on trees to a class of phylogenetic networks called separable networks, which will include orchard networks. Networks are becoming increasingly important for their ability to represent reticulation events, such as hybridization, in evolutionary history. We provide a function from the space of internally multi-labelled phylogenetic networks, a more generic graph structure than phylogenetic networks where the reticulations are also labelled, to a polynomial ring. We prove that the separability condition allows us to characterize, via the polynomial, the phylogenetic networks with the same number of leaves and same number of reticulations by considering their internally labelled versions. While the invariant for trees is a polynomial in [Formula: see text] where n is the number of leaves, the invariant for internally multi-labelled phylogenetic networks is an element of [Formula: see text], where r is the number of reticulations in the network. When the networks are considered without leaf labels the number of variables reduces to r + 2.

PMID:35594308 | DOI:10.1371/journal.pone.0268181

PLoS One. 2022 May 20;17(5):e0268820. doi: 10.1371/journal.pone.0268820. eCollection 2022.

ABSTRACT

Human immunodeficiency virus (HIV)-1 infection during pregnancy reduces the transplacental transfer of protective maternal antibodies needed to confer immunity during early postnatal life. However, the mediation of MicroRNA in this dysregulation is not well understood MicroRNAs 3181 and 199a have been shown to mediate neonatal Fc receptor (FcRn)-like transmembrane antibody transfer and endocytosis respectively but their expression levels in the placenta and plasma in women living with HIV have not been extensively investigated. The objective of this study was to determine how the expression levels of miR-3181 and miR-199a in the placenta and plasma are affected in women chronically infected with HIV who are on antiretroviral therapy (ART) and are virally suppressed at delivery. In this pilot case-control study, plasma and placenta biopsies were obtained from 36 (18 HIV+ and 18 HIV-) Cameroonian women at delivery. MicroRNAs 3181 and 199a expression levels were measured using RT-qPCR, data was analyzed using SPSS22.0 and R 3.60, and p values below 0.05 were considered statistically significant. All the HIV-infected women were on known ART regimens and were virally suppressed. There was no significant difference in the levels of miR-3181 (p>0.05) in the placenta and plasma amongst HIV-infected and HIV uninfected women. The expression levels of miR-199a were significantly greater in the plasma compared to the placenta of HIV+ (p = 0.00005) and HIV- (p = 0.027) women. Moreover, there was a significantly higher (p = 0.02) level of miR-199a in the plasma of women with HIV and their uninfected counterparts. Linear regression models adjusted for systolic pressure showed no significant difference (p>0.05) in the levels of miR-199a and miR-3181 in both the placenta and plasma due to HIV infection. Our findings suggest that even though ART uptake and viral suppression might help in maintaining miR3181 and miR199a levels in the placenta of women with HIV at comparative levels to those of their HIV negative counterparts, the significantly higher levels of miR-199a in the plasma of women with HIV compared to the placenta might highlight lurking systemic dangers and requires further investigation.

PMID:35594307 | DOI:10.1371/journal.pone.0268820

PLoS One. 2022 May 20;17(5):e0268186. doi: 10.1371/journal.pone.0268186. eCollection 2022.

ABSTRACT

INTRODUCTION: Malaria is a severe health threat in the World, mainly in Africa. It is the major cause of health problems in which the risk of morbidity and mortality associated with malaria cases are characterized by spatial variations across the county. This study aimed to investigate the spatial patterns and predictors of malaria distribution in Ethiopia.

METHODS: A weighted sample of 15,239 individuals with rapid diagnosis test obtained from the Central Statistical Agency and Ethiopia malaria indicator survey of 2015. Global Moran’s I and Moran scatter plots were used in determining the distribution of malaria cases, whereas the local Moran’s I statistic was used in identifying exposed areas. The auto logistics spatial binary regression model was used to investigate the predictors of malaria.

RESULTS: The final auto logistics regression model was reported that male clients had a positive significant effect on malaria cases as compared to female clients [AOR = 2.401, 95% CI: (2.125-2.713) ]. The distribution of malaria across the regions was different. The highest incidence of malaria was found in Gambela [AOR = 52.55, 95%CI: (40.54-68.12)] followed by Beneshangul [AOR = 34.95, 95%CI: (27.159-44.963)]. Similarly, individuals in Amhara [AOR = 0.243, 95% CI:(0.195-0.303], Oromiya [AOR = 0.197, 955 CI: (0.158-0.244)], Dire Dawa [AOR = 0.064, 95%CI(0.049-0.082)], Addis Ababa[AOR = 0.057,95%CI:(0.044-0.075)], Somali[AOR = 0.077,95%CI:(0.059-0.097)], SNNPR[OR = 0.329, 95%CI: (0.261-0.413)] and Harari [AOR = 0.256, 95%CI:(0.201-0.325)] were less likely to had low incidence of malaria as compared with Tigray. Furthermore, for one meter increase in altitude, the odds of positive rapid diagnostic test (RDT) decreases by 1.6% [AOR = 0.984, 95% CI: (0.984-0.984)]. The use of a shared toilet facility was found as a protective factor for malaria in Ethiopia [AOR = 1.671, 95% CI: (1.504-1.854)]. The spatial autocorrelation variable changes the constant from AOR = 0.471 for logistic regression to AOR = 0.164 for auto logistics regression.

CONCLUSIONS: This study found that the incidence of malaria in Ethiopia had a spatial pattern which is associated with socio-economic, demographic, and geographic risk factors. Spatial clustering of malaria cases had occurred in all regions, and the risk of clustering was different across the regions. The risk of malaria was found to be higher for those who live in soil floor-type houses as compared to those who lived in cement or ceramics floor type. Similarly, households with thatched, metal and thin, and other roof-type houses have a higher risk of malaria than ceramics tiles roof houses. Moreover, using a protected anti-mosquito net was reducing the risk of malaria incidence.

PMID:35594290 | DOI:10.1371/journal.pone.0268186