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Effect of a Web-Based Heartfulness Program on the Mental Well-Being, Biomarkers, and Gene Expression Profile of Health Care Students: Randomized Controlled Trial

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

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Nevin Manimala Statistics

Enhanced Brain Tumor Classification Through Optimized Semantic Preserved Generative Adversarial Networks

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

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Transcutaneous Auricular Vagus Nerve Stimulation for Chronic Insomnia Disorder: A Randomized Clinical Trial

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

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Phytoliths in dicotyledons occurring in North-western Europe: Establishing a baseline

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

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Refining Flash Visual Evoked Potential Analysis in Rats: A Novel Approach Using Bilateral Epidural Electrodes

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

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Nevin Manimala Statistics

Adenoma Detection Rates by Physicians and Subsequent Colorectal Cancer Risk

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

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Students Needing Remediation in Preclinical Course Failures in a DVM Program: A 10-Year Analytic Study

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

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Health-related quality of life in 62 patients with diffuse low-grade glioma during a non-therapeutic and progression-free phase: a cross-sectional study

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

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Dataset augmentation with multiple contrasts images in super-resolution processing of T1-weighted brain magnetic resonance images

Radiol Phys Technol. 2024 Dec 16. doi: 10.1007/s12194-024-00871-1. Online ahead of print.

ABSTRACT

This study investigated the effectiveness of augmenting datasets for super-resolution processing of brain Magnetic Resonance Images (MRI) T1-weighted images (T1WIs) using deep learning. By incorporating images with different contrasts from the same subject, this study sought to improve network performance and assess its impact on image quality metrics, such as peak signal-to-noise ratio (PSNR) and structural similarity (SSIM). This retrospective study included 240 patients who underwent brain MRI. Two types of datasets were created: the Pure-Dataset group comprising T1WIs and the Mixed-Dataset group comprising T1WIs, T2-weighted images, and fluid-attenuated inversion recovery images. A U-Net-based network and an Enhanced Deep Super-Resolution network (EDSR) were trained on these datasets. Objective image quality analysis was performed using PSNR and SSIM. Statistical analyses, including paired t test and Pearson’s correlation coefficient, were conducted to evaluate the results. Augmenting datasets with images of different contrasts significantly improved training accuracy as the dataset size increased. PSNR values ranged 29.84-30.26 dB for U-Net trained on mixed datasets, and SSIM values ranged 0.9858-0.9868. Similarly, PSNR values ranged 32.34-32.64 dB for EDSR trained on mixed datasets, and SSIM values ranged 0.9941-0.9945. Significant differences in PSNR and SSIM were observed between models trained on pure and mixed datasets. Pearson’s correlation coefficient indicated a strong positive correlation between dataset size and image quality metrics. Using diverse image data obtained from the same subject can improve the performance of deep-learning models in medical image super-resolution tasks.

PMID:39680317 | DOI:10.1007/s12194-024-00871-1

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Is COVID-19 Still a Threat? An Expert Opinion Review on the Continued Healthcare Burden in Immunocompromised Individuals

Adv Ther. 2024 Dec 16. doi: 10.1007/s12325-024-03043-0. Online ahead of print.

ABSTRACT

Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has had a profound global impact. The emergence of several variants during the pandemic has presented numerous challenges in preventing and managing this disease. The development of vaccines has played a pivotal role in controlling the pandemic, with a significant portion of the global population being vaccinated. This, along with the emergence of less virulent SARS-CoV-2 variants, has led to a reduction in the severity of COVID-19 outcomes for the overall population. Nevertheless, individuals with immunocompromising conditions continue to face challenges given their suboptimal response to vaccination and vulnerability to severe COVID-19. This expert review synthesizes recent published evidence regarding the economic and human impact of COVID-19 on such individuals. The literature suggests that rates of hospitalization, intensive care unit admission, and mechanical ventilation use were high during the pre-Omicron era, and remained high during Omicron and later, despite vaccination for this population. Moreover, studies indicated that these individuals experienced a negative impact on their mental health and health-related quality of life (HRQoL) compared to those without immunocompromising conditions, with elevated levels of anxiety, depression, and distress reported. Further, these individuals with immunocompromising conditions experienced substantial costs associated with COVID-19 and loss of income during the pandemic, though the evidence on the economic burden of COVID-19 in such individuals is limited. Generally, COVID-19 has increased healthcare resource use and costs, impaired mental health, and reduced HRQoL in those with varied immunocompromising conditions compared to both those without COVID-19 and the general population-underscoring the importance of continued real-world studies. Ongoing research is crucial to assess the ongoing burden of COVID-19 in vaccinated individuals with immunocompromising conditions who are still at risk of severe COVID-19 outcomes to ensure their needs are not disproportionately worse than the general population.

PMID:39680311 | DOI:10.1007/s12325-024-03043-0