Tag: pubmed

JMIR Public Health Surveill. 2024 Dec 16;10:e58391. doi: 10.2196/58391.

ABSTRACT

BACKGROUND: China is a country with a high burden of hepatitis B (Hep B) but a low treatment rate. One of the key reasons for the low treatment rate is the inadequate health literacy (HL) of the people, which may affect the awareness and knowledge of Hep B and its treatment, as well as the ability to actively and correctly seek medical resources.

OBJECTIVE: This study analyzed how HL contributed to the scale-up of antiviral treatment of Hep B in China. We expect that the findings of this study could be used to inform resource allocation for health education and other approaches intending to improve the HL of the Chinese population, thus facilitating the nationwide scale-up of Hep B treatment and contributing to the achievement of the 2030 goal of eliminating viral hepatitis as a major public health threat in China.

METHODS: We used the two-stage least squares regression method and adopted the mobile phone penetration rate as the instrumental variable to estimate the effect of improved HL on the number of 12-month standard Hep B antiviral treatments in China based on the panel data of 31 provinces from 2013 to 2020.

RESULTS: In the cross-sectional dimension, the higher the HL, the higher the number of treatments in the provinces in a specific year. In the time series dimension, the number of treatments in a specific province increased with the improvement of HL over time. After controlling the time-invariant inherent attributes of provinces, the instrumental variable estimation with two-stage least squares regression based on the province fixed effect model found that for every 1% increase of HL in each province, the number of treatments increased by 7.15% (0.0715 = e0.0691 – 1; P<.001). Such an increase turned to 5.19% (0.0519 = e0.0506 – 1; P<.001) for the analysis targeting the observation time from 2013 to 2019, as the data of 2020 were removed when the COVID-19 pandemic started. The study found no statistically significant effect of HL on the number of Hep B treatments in the provinces with higher newly reported Hep B incidence and lower gross domestic product per capita.

CONCLUSIONS: Our findings suggest that improved HL of the population is an important favorable facilitator for the scale-up of Hep B treatment in China. Building awareness and knowledge of Hep B and its treatment can help individuals understand their health status, ensuring a healthier lifestyle and appropriate health care-seeking behaviors and health care service utilization, so that people can be diagnosed and treated timely and appropriately. Enhancing resource allocation to improve the overall HL of the population and sending Hep B-specific messages to the infected people would be a feasible and effective approach to scale-up the treatment of Hep B in low- and middle-income settings with limited resources, and contribute to achieving the 2030 global goal of eliminating viral hepatitis as a major public health threat.

PMID:39680440 | DOI:10.2196/58391

Elife. 2024 Dec 16;13:RP96566. doi: 10.7554/eLife.96566.

ABSTRACT

Studying and understanding the code of large neural populations hinge on accurate statistical models of population activity. A novel class of models, based on learning to weigh sparse nonlinear Random Projections (RP) of the population, has demonstrated high accuracy, efficiency, and scalability. Importantly, these RP models have a clear and biologically plausible implementation as shallow neural networks. We present a new class of RP models that are learned by optimizing the randomly selected sparse projections themselves. This ‘reshaping’ of projections is akin to changing synaptic connections in just one layer of the corresponding neural circuit model. We show that Reshaped RP models are more accurate and efficient than the standard RP models in recapitulating the code of tens of cortical neurons from behaving monkeys. Incorporating more biological features and utilizing synaptic normalization in the learning process, results in accurate models that are more efficient. Remarkably, these models exhibit homeostasis in firing rates and total synaptic weights of projection neurons. We further show that these sparse homeostatic reshaped RP models outperform fully connected neural network models. Thus, our new scalable, efficient, and highly accurate population code models are not only biologically plausible but are actually optimized due to their biological features. These findings suggest a dual functional role of synaptic normalization in neural circuits: maintaining spiking and synaptic homeostasis while concurrently optimizing network performance and efficiency in encoding information and learning.

PMID:39680435 | DOI:10.7554/eLife.96566

JMIR Bioinform Biotechnol. 2024 Dec 16;5:e65506. doi: 10.2196/65506.

ABSTRACT

BACKGROUND: Health care students often experience high levels of stress, anxiety, and mental health issues, making it crucial to address these challenges. Variations in stress levels may be associated with changes in dehydroepiandrosterone sulfate (DHEA-S) and interleukin-6 (IL-6) levels and gene expression. Meditative practices have demonstrated effectiveness in reducing stress and improving mental well-being.

OBJECTIVE: This study aims to assess the effects of Heartfulness meditation on mental well-being, DHEA-S, IL-6, and gene expression profile.

METHODS: The 78 enrolled participants were randomly assigned to the Heartfulness meditation (n=42, 54%) and control (n=36, 46%) groups. The participants completed the Perceived Stress Scale (PSS) and Depression Anxiety Stress Scale (DASS-21) at baseline and after week 12. Gene expression with messenger RNA sequencing and DHEA-S and IL-6 levels were also measured at baseline and the completion of the 12 weeks. Statistical analysis included descriptive statistics, paired t test, and 1-way ANOVA with Bonferroni correction.

RESULTS: The Heartfulness group exhibited a significant 17.35% reduction in PSS score (from mean 19.71, SD 5.09 to mean 16.29, SD 4.83; P<.001) compared to a nonsignificant 6% reduction in the control group (P=.31). DASS-21 scores decreased significantly by 27.14% in the Heartfulness group (from mean 21.15, SD 9.56 to mean 15.41, SD 7.87; P<.001) while it increased nonsignificantly by 17% in the control group (P=.04). For the DASS-21 subcomponents-the Heartfulness group showed a statistically significant 28.53% reduction in anxiety (P=.006) and 27.38% reduction in stress (P=.002) versus an insignificant 22% increase in anxiety (P=.02) and 6% increase in stress (P=.47) in the control group. Further, DHEA-S levels showed a significant 20.27% increase in the Heartfulness group (from mean 251.71, SD 80.98 to mean 302.74, SD 123.56; P=.002) compared to an insignificant 9% increase in the control group (from mean 285.33, SD 112.14 to mean 309.90, SD 136.90; P=.10). IL-6 levels showed a statistically significant difference in both the groups (from mean 4.93, SD 1.35 to mean 3.67, SD 1.0; 28.6%; P<.001 [Heartfulness group] and from mean 4.52, SD 1.40 to mean 2.72, SD 1.74; 40%; P<.001 [control group]). Notably, group comparison at 12 weeks revealed a significant difference in perceived stress, DASS-21 and its subcomponents, and IL-6 (all P<.05/4). The gene expression profile with messenger RNA sequencing identified 875 upregulated genes and 1539 downregulated genes in the Heartfulness group compared to baseline, and there were 292 upregulated genes and 1180 downregulated genes in the Heartfulness group compared to the control group after the intervention.

CONCLUSIONS: Heartfulness practice was associated with decreased depression, anxiety, and stress scores and improved health measures in DHEA-S and IL-6 levels. The gene expression data point toward possible mechanisms of alleviation of symptoms of stress, anxiety and depression.

TRIAL REGISTRATION: ISRCTN Registry ISRCTN82860715; https://doi.org/10.1186/ISRCTN82860715.

PMID:39680432 | DOI:10.2196/65506

Microsc Res Tech. 2024 Dec 16. doi: 10.1002/jemt.24767. Online ahead of print.

ABSTRACT

Brain tumor is a most dangerous disease and requires accurate diagnosis in a short period to ensure the best treatment. Traditional methods for brain tumor classification (BTC) are quite effective, even though usually resulting in clinical manual analysis, which takes more time and prone to errors. Initially, the input image is collected from Brain Tumor dataset. The gathered image is given to preprocessing. In preprocessing stage, trust-based distributed set-membership filtering (TDSF) is used to remove the noise. The preprocessed output is fed to the quaternion offset linear canonical transform (QOLCT) for Grayscale statistic and Haralick texture features extraction. Then the extracted features are fed to the Semantic-Preserved Generative Adversarial Network (SPGAN) for classifying the brain tumor into Glioma, Meningioma and Pituitary. Finally, Hunger Games Search Optimization (HGSO) is used to enhance the weight parameters of SPGAN. The proposed BTC-SPGAN-HGSO method attains the accuracies of 99.72% for Glioma, 99.65% for Meningioma, 99.52% for Pituitary and lowest MSE values across all tumor types, with 0.45% for Glioma, 0.39% for Meningioma, and 0.5% for Pituitary, which performs better than existing models. The simulation results highlight the effectiveness of the proposed BTC-SPGAN-HGSO approach in improving the accuracy of BTC and assist neurologists and physicians make exact decisions of diagnostic.

PMID:39680418 | DOI:10.1002/jemt.24767

JAMA Netw Open. 2024 Dec 2;7(12):e2451217. doi: 10.1001/jamanetworkopen.2024.51217.

ABSTRACT

IMPORTANCE: Evidence from randomized clinical trials of transcutaneous auricular vagus nerve stimulation (taVNS) for chronic insomnia disorder is lacking.

OBJECTIVE: To evaluate the efficacy and safety of taVNS for chronic insomnia compared with the sham taVNS.

DESIGN, SETTING, AND PARTICIPANTS: This randomized clinical trial was conducted from October 2021 to December 2022 at a single center in Beijing, China. Patients with chronic insomnia disorder with a Pittsburgh Sleep Quality Index (PSQI) of at least 8 were enrolled. Statistical analysis was performed from June to September 2023.

INTERVENTIONS: Patients were allocated to the active taVNS group or sham taVNS group with a 1:1 ratio. Both groups received the stimulation for 30 minutes each time, twice a day, 5 consecutive days a week, with an 8-week treatment and a 12-week follow-up.

MAIN OUTCOMES AND MEASURES: The primary end point was the mean change from baseline through week 8 in PSQI scores. Minimal clinically important difference was 2.5 points. Secondary outcomes included mental health, sleepiness, and fatigue. Safety was also evaluated.

RESULTS: A total of 72 participants were randomized to either active taVNS group (36 participants; mean [SD] age, 45.2 [14.5] years; 27 [75.0%] female) or the sham taVNS group (36 participants; mean [SD] age, 44.6 [13.9] years; 31 [86.1%] female); 68 participants completed the 8-week intervention. The least-square mean changes from baseline to week 8 in PSQI were -8.2 (95% CI, -9.3 to -7.0) points in the taVNS group and -3.9 (95% CI, -5.1 to -2.7) points in the sham group. Both groups experienced statistically significant improvements from before to after the intervention. However, active taVNS showed a clinically meaningful 4.2-point greater reduction (95% CI, -5.9 to -2.6 points; P < .001; Cohen d effect size, 1.2) in PSQI compared with the sham group (minimal clinically important difference = 2.5 points). Secondary outcomes, including mental health and fatigue, showed similar favorable results. The efficacy of taVNS was sustained throughout the 20-week study period.

CONCLUSIONS AND RELEVANCE: In this randomized clinical trial, taVNS significantly reduced insomnia severity. Clinically meaningful enhancements in PSQI scores were observed compared with sham stimulation, with the benefits of taVNS sustained over a 20-week period. Future multicenter clinical trials with large sample sizes are needed to validate its effectiveness across diverse populations.

TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR2100051319.

PMID:39680406 | DOI:10.1001/jamanetworkopen.2024.51217

Ann Bot. 2024 Dec 16:mcae217. doi: 10.1093/aob/mcae217. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: The absence of a modern plant-based ‘dicotyledon’ phytolith reference baseline impedes the accurate interpretation of fossil phytolith records in archaeological and palaeoecological research within North-western Europe. This study aims to fill this gap by documenting and analysing the phytolith record from modern dicotyledon taxa occurring in this region.

METHODS: Phytoliths were extracted from several plant parts of 117 plant specimens representing 74 species (1-2 specimens/species). The study employed light microscopy to examine phytolith production (non-producer, trace, common, or abundant) and phytolith assemblage composition. The data were analysed statistically to (a) determine the influence of taxonomy and plant part on phytolith presence (absent/present) using a Mixed Model, (b) assess phytolith assemblage variation using a Permutational Multivariate Analysis of Variance (PerMANOVA), and (c) identify patterns among sample groups including segregation for plant part, life form (forbs vs shrubs/trees), and order using a Linear Discriminant Analyses (LDA).

KEY RESULTS: Morphotype analysis reveals diagnostic morphotypes and features for specific plant families, genera, and plant parts. LDA effectively segregated plant parts and life forms, though taxonomic groupings showed limited segregation. Phytolith presence (absent/present) was found to vary, influenced by both plant part and taxonomy. For species examined through two specimens, although phytolith production varied considerably, phytolith assemblage composition was consistent.

CONCLUSIONS: This study establishes a ‘dicotyledon’ phytolith baseline for North-western Europe, showing that the phytolith record can be informative in terms of plant part and life form and that several phytolith morphotypes and/or features are taxonomically diagnostic below ‘dicotyledon’ level. The findings constitute a foundation upon which future research can build, refining and expanding our knowledge of the North-western European region.

PMID:39680404 | DOI:10.1093/aob/mcae217

Transl Vis Sci Technol. 2024 Dec 2;13(12):24. doi: 10.1167/tvst.13.12.24.

ABSTRACT

PURPOSE: Visual evoked potentials (VEPs) are electrical signals generated at the visual cortex following visual stimulation. Flash VEPs (fVEPs) are produced by global retinal stimulation and are considered an objective measure of the integrity of the entire visual pathway. However, fVEP measurements are highly sensitive to external variables, making relative comparisons of the fVEP waveforms between the two eyes in the same individual challenging.

METHODS: We used the rodent non-arteritic anterior ischemic optic neuropathy (rNAION) model to induce unilateral ischemic optic neuropathy. The severity of optic disc edema was measured with spectral-domain optical coherence tomography, and visual acuity was measured using a virtual optokinetic system. We developed a procedure utilizing implanted bilateral epidural electrodes and derived a mathematical formula to accurately estimate functional differences between the optic nerves. Immunohistology was performed to quantify retinal ganglion cell (RGC) survival using stereology.

RESULTS: Compared to subcutaneous methods, the new approach significantly improves the signal-to-noise ratio and is more repeatable when comparing the two eyes. The derived formula accounts for asymmetry in the afferent inputs to the visual cortex. Visual function calculated using the formula correlates strongly with other recognized metrics of visual function, including RGC survival and visual acuity.

CONCLUSIONS: We have developed a repeatable and accurate method to calculate the relative visual function of diseased optic nerves compared with a contralateral control eye.

TRANSLATIONAL RELEVANCE: Our novel method improves fVEP measurement sensitivity and accuracy in rodent preclinical trials, reducing the number of animals needed to achieve statistical significance.

PMID:39680393 | DOI:10.1167/tvst.13.12.24

JAMA. 2024 Dec 16. doi: 10.1001/jama.2024.22975. Online ahead of print.

ABSTRACT

IMPORTANCE: Patients of physicians with higher adenoma detection rates (ADRs) during colonoscopy have lower colorectal cancer (CRC) risk after screening colonoscopy (ie, postcolonoscopy CRC). Among physicians with an ADR above the recommended threshold, it is unknown whether improving ADR is associated with a lower incidence of CRC in their patients.

OBJECTIVE: To determine the association of improved ADR in physicians with a range of ADR values at baseline with CRC incidence among their patients.

DESIGN, SETTING, AND PARTICIPANTS: A total of 789 physicians in the Polish Colonoscopy Screening Program were studied between 2000 and 2017, with final follow-up on December 31, 2022. Joinpoint regression analyses were used to identify trends between changes in ADR and postcolonoscopy CRC incidence. Rates of CRC after colonoscopy were compared between physicians whose ADR improved and those without improvement. ADR improvement was defined as either an improvement by at least 1 ADR sextile category or remaining in the highest category.

EXPOSURE: Physician ADR.

MAIN OUTCOMES AND MEASURES: Association of improved ADR with postcolonoscopy CRC incidence.

RESULTS: Of 485 615 patients (mean [SD] age, 57 [5.41] years; 60% female), 1873 CRC diagnoses and 474 CRC-related deaths occurred during a median follow-up of 10.2 years. Among individual physicians at baseline, median (IQR) ADR was 21.8% (15.9%-28.2%) and maximum ADR was 63.0%. Joinpoint regression showed a change in CRC incidence trends at an ADR level of 26%, corresponding to a CRC incidence of 27.1 per 100 000 person-years. Patients of physicians whose ADR was less than 26% at baseline and improved during follow-up had a postcolonoscopy CRC incidence of 31.8 (95% CI, 29.5-34.3) per 100 000 person-years, compared with 40.7 (95% CI, 37.8-43.8) per 100 000 person-years for patients of physicians with an ADR of less than 26% at baseline who did not improve during follow-up (difference, 8.9/100 000 person-years [95% CI, 5.06-12.74]; P < .001). Patients of physicians whose ADR was above 26% at baseline and improved during follow-up had a postcolonoscopy CRC incidence of 23.4 (95% CI, 18.4-29.8) per 100 000 person-years, compared with 22.5 (95% CI, 18.3-27.6) for patients of physicians whose ADR was above 26% at baseline and did not improve during follow-up (difference, 0.9/100 000 person-years [95% CI, -6.46 to 8.26]; P = .80).

CONCLUSIONS AND RELEVANCE: In this observational study, improved ADR over time was statistically significantly associated with lower CRC risk in patients who underwent colonoscopy compared with absence of ADR improvement, but only among patients whose physician had a baseline ADR of less than 26%.

PMID:39680377 | DOI:10.1001/jama.2024.22975

J Vet Med Educ. 2024 Dec 16:e20240065. doi: 10.3138/jvme-2024-0065. Online ahead of print.

ABSTRACT

Remediation of preclinical course failures in the DVM program at Purdue University College of Veterinary Medicine began in 2010. We set out to understand whether some students were more likely than others to use remediation opportunities and succeed. Student demographics, undergraduate (UG) experiences, including institution attended and major studied, UG performance as measured by grade point average (uGPA), and extent of academic difficulties in DVM years 1-3 were studied at univariate levels to determine which students more often failed ≥1 courses, remediated ≥1 courses, and were successful in all remediation attempts. Among 815 students in DVM Classes 2014-2023, 157 failed ≥1 courses. Risk factors associated with failing ≥1 courses and with unsuccessful remediation were identified using multiple logistic regression analysis. Unsuccessful remediation, resulting in student’s academic attrition, was defined as not succeeding at remediation of all failed courses, including being ineligible for or not attempting remediation. Risk factors were considered statistically significant at P value <0.05. Lower uGPA, having attended a minority-serving institution, and being an underrepresented minority or an international student were associated with increased likelihood of failing ≥1 courses. However, the only factors associated with unsuccessful remediation were failing ≥3 courses in DVM years 1-3 and failing at least one course in DVM year 1. No demographic or UG educational background is associated with unsuccessful remediation. Taken together, our models suggest that being at risk of failing ≥1 courses in DVM years 1-3 did not inevitably put students at risk of attrition when remediation opportunities were provided. However, an increasing number of course failures and failures beginning in DVM year 1 increased the risk of unsuccessful remediation. Early intervention to minimize academic difficulties in DVM program may mitigate risk of student attrition.

PMID:39680375 | DOI:10.3138/jvme-2024-0065

J Neurooncol. 2024 Dec 16. doi: 10.1007/s11060-024-04888-9. Online ahead of print.

ABSTRACT

PURPOSE: Few studies have evaluated the health-related quality of life (HRQoL) of patients with diffuse low-grade glioma (LGG) during a clinical and radiological monitoring period. We report a cross sectional cohort study of HRQoL in patients with LGG and compare the results with normative population data. We then explore factors associated with HRQoL.

METHODS: We used the European Organisation for Research and Treatment of Cancer QLQ-C30, BN-20 and the Hospital Anxiety and Depression Scale (HADS) to evaluate HRQoL. Averaged QLQC30 and HADS scores were compared with scores of a normative population. A general linear model multivariate analysis of variance was used to investigate the association between HRQoL and independent factors.

RESULTS: A total of 62 patients with LGG completed HRQoL questionnaires. Compared with a normative population, LGG patients reported statistical and clinically significant lower cognitive, emotional, role and social functioning. Fatigue, anxiety, depression and sleep disturbances were frequently reported. Awake surgery and preserved high Karnofsky Performance Status were found to be independent prognostic factors for better global HRQoL, while radiotherapy was associated with worsened HRQoL.

CONCLUSION: Despite a non-therapeutic and progression free phase, LGG patients report noticeable limitations in several HRQoL subscales. Our study highlights the importance of HRQoL assessment not only at diagnosis or during active therapeutic stage. Further studies are needed to develop better adapted tools of HRQoL assessment.

PMID:39680337 | DOI:10.1007/s11060-024-04888-9