Tag: pubmed

Am J Biol Anthropol. 2024 Dec 8:e25042. doi: 10.1002/ajpa.25042. Online ahead of print.

ABSTRACT

OBJECTIVES: Previous studies report that geometric measures of incisor size and curvature in extant anthropoid primates correspond to dietary differences. However, other methodologies of assessing incisor shape variation, such as dental topographic analysis, have not been considered.

MATERIALS AND METHODS: This study measures Relief Index (RFI), linear dimensions, and curvature of central mandibular incisors (I₁) for a sample of extant anthropoids (n = 107). The utility of these measures in enhancing dietary separations across Anthropoidea is further investigated using traditional and phylogenetic statistics, principal component analysis, and multinomial logistic regression.

RESULTS: Two-way ANOVAs find significant dietary differences and no sexual differences in I₁ height, width, breadth, and RFI across crown anthropoids. Phylogenetic ANOVAs also detect significant dietary differences in these measures despite the presence of high and significant phylogenetic signal in height and RFI, indicating that dietary signals are robust. Predictive models combining I₁ geometry and RFI outperform those using solely I₁ geometry. A mixed-feeding ecology is inferred for the fossil platyrrhine Antillothrix.

DISCUSSION: Our findings indicate that I₁ RFI and linear dimensions are robust dietary proxies in anthropoid primates that may be beneficial to future ecomorphological and paleontological analyses. The presence of phylogenetic signal merits further investigation, and we recommend a nuanced approach if applying I₁ RFI or height as a dietary proxy for fossil primates.

PMID:39648302 | DOI:10.1002/ajpa.25042

Clin Oral Implants Res. 2024 Dec 8. doi: 10.1111/clr.14387. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the performance and clinical outcome of vertical and horizontal bone augmentation (VHBA) in posterior maxillary regions combining lateral window sinus floor elevation (LWSFE) with a horizontal bone shell technique applying the maxillary facial sinus wall as a bone plate.

MATERIALS AND METHODS: In 18 patients, LWSFE was combined with a horizontal bone shield augmentation procedure utilizing the maxillary facial sinus bone wall as a lateral bone plate. Both the sinus cavity and the lateral bone box created were grafted with a mixture of autogenous bone/venous blood and bovine bone mineral. The primary aim was to assess the performance of combined techniques enabling subsequent implant placement. Using radiographic measurements (preoperative, after VHBA, at implant placement, and at follow-up), bone gain/reduction of augmented horizontal ridge width (HRW) and vertical bone height (VBH) were evaluated. Additionally, clinical outcome assessing implant survival/success rate, marginal bone loss (MBL), and implant health (mucositis/peri-implantitis) was evaluated.

RESULTS: For the combined VHBA techniques, HRW and VBH increased significantly (p < 0.001) from preoperative 3.5 ± 1.4 mm/3.6 ± 2.1 mm to 9.7 ± 1.9 mm/18.0 ± 1.6 mm post-augmentation. However, HRW and VBH dimensions decreased up to 8.9 ± 1.8 mm/17.1 ± 1.4 mm at implant placement and 8.6 ± 1.7 mm/16.7 ± 1.3 mm at follow-up evaluation (3.8 ± 1.8 years; p < 0.001, respectively). Augmented bone reduction was significantly higher (-7.7%) between the augmentation procedure and implant placement than in the post-implant-placement period (-2.5%). All implants survived (100%) representing peri-implant MBL of -0.9 ± 0.7 mm, pocket depth of 3.4 + 1.8 mm, and prevalences of 5%/0% for peri-implant mucositis/peri-implantitis.

CONCLUSION: The combination of horizontal bone augmentation using local bone shield transfer from the maxillary facial sinus wall with LWSFE enables sufficient reconstruction of maxillary posterior ridge.

PMID:39648281 | DOI:10.1111/clr.14387

Transfusion. 2024 Dec 8. doi: 10.1111/trf.18090. Online ahead of print.

ABSTRACT

BACKGROUND: Extracorporeal photopheresis (ECP) has been demonstrated as an effective treatment for graft-versus-host disease (GvHD). The inline system was developed by Therakos in 1987. Recently, Fresenius Kabi implemented an integration of cell separator Amicus and a UVA photoactivation device (Phelix), realizing an inline photopheresis system.

STUDY DESIGN AND METHODS: In 2022 we designed a prospective paired crossover trial (NCT05718674) comparing two integrated ECP protocols: Therakos CELLEX and Amicus ECP system. Twenty patients affected by corticosteroid resistant GvHD were submitted to 80 ECP, 40 paired procedures.

RESULTS: All procedures were well tolerated, with no significant differences in procedure duration. CELLEX cell product showed higher granulocytes and platelet content, while Amicus cell product exhibited higher enrichment of lymphocytes, resulting in significantly higher MNC purity (92.9% vs. 84%). A significantly higher granulocytes and platelets absolute content was observed in CELLEX cell products, while Amicus cell products showed a significantly higher number of TNCs and MNCs. Differences in granulocyte and platelet content remained significant even after normalization of the data according to blood volume processed. These findings are confirmed by a statistically significant higher CE2% for CELLEX for granulocytes and platelets along with the lack of significant difference observed for TNCs and MNCs.

DISCUSSION: Our analysis shows differences in the characteristics of the procedure and the cell product. Anyway, both devices are effective for performing ECP procedure, as they collect a cell product suitable for photopheresis. At present, our results represent the first data set comparing two available inline ECP devices.

PMID:39648279 | DOI:10.1111/trf.18090

Drug Dev Ind Pharm. 2024 Dec 8:1-13. doi: 10.1080/03639045.2024.2434640. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this study is to create predictive models utilizing machine learning algorithms, including Artificial Neural Networks (ANN), k-nearest neighbor (kNN), support vector machines (SVM), and linear regression, to predict critical quality attributes (CQAs) such as hardness, friability, and disintegration time of fast disintegrating tablets (FDTs).

METHODS: A dataset of 864 batches of FDTs was generated by varying binder types and amounts, disintegrants, diluents, punch sizes, and compression forces. Preprocessing steps included normalizing numerical features based on industry standards, one-hot encoding for categorical variables, and addressing outliers to ensure data consistency. Four machine learning models were trained and evaluated on R² values and mean squared error (MSE). Feature importance was analyzed using permutation importance, and statistical validation (p < 0.05) and confidence intervals were computed for model performance. The ‘differential_evolution’ function was used to optimize the formulation.

RESULTS: Among the models, ANN demonstrated the highest predictive accuracy, achieving R² values up to 0.9550 with the lowest MSE across training and test datasets, outperforming kNN, SVM, and linear regression. The ANN’s ability to model complex, non-linear interactions between formulation variables was statistically significant, as validated through six checkpoint batches of acetylsalicylic acid FDTs. The feature importance analysis revealed compression force, binder type, and punch size as the most influential factors affecting hardness, while disintegrant type influenced friability. The ‘differential_evolution’ function effectively optimized the CQAs, resulting in FDTs with ideal characteristics.

CONCLUSION: The ANN model, integrated with differential evolution, provided a robust tool for optimizing FDT formulations by accurately predicting CQAs and reducing the need for extensive experimental trials. Compared to traditional optimization methods, ANN excels in capturing intricate multi-variable relationships, making it a valuable approach for scaling beyond acetylsalicylic acid to other formulations. This method enhances the consistency and efficiency of tablet formulation, supporting broader pharmaceutical applications.

PMID:39648277 | DOI:10.1080/03639045.2024.2434640

Int J Geriatr Psychiatry. 2024 Dec;39(12):e70017. doi: 10.1002/gps.70017.

ABSTRACT

BACKGROUND: Loneliness among older adults, is a subjective experience and a public health issue in aging societies. Psychometrically sound and culturally sensitive measures are needed for developing precisely targeted interventions in culturally distinct groups. This study tested the Short-Form UCLA Loneliness Scale (ULS-8) among Chinese older adults.

METHOD: Confirmatory factor analysis, internal consistency, and the correlation with the single question of loneliness were conducted with a sample of Chinese older adults. Rasch analyses assessed the unidimensionality, response category functioning, item difficulty, and targeting of the ULS-8 for older Chinese adults.

RESULTS: Data from 347 Chinese older adults (mean age 71.36 ± 9.51 years) were analyzed; 74.64% of the participants were female. The ULS-8 showed acceptable internal consistency and criterion validity in Classical Test Theory. Confirmatory factor analysis and Rasch analysis indicated that the ULS-8 did not demonstrate a unidimensional structure. Additionally, Rasch analysis revealed (1) a misfit in item 3, indicating a problem with construct validity; (2) the need to combine response categories; and (3) that Chinese older adults are less likely to endorse a high level of loneliness when using the ULS-8.

CONCLUSIONS: To ascertain the adequacy of the loneliness measure, it is crucial to customize a new short version of the loneliness scale for Chinese older adults through Rasch analysis.

PMID:39648272 | DOI:10.1002/gps.70017

Neurochem Res. 2024 Dec 9;50(1):51. doi: 10.1007/s11064-024-04307-5.

ABSTRACT

This study aimed to assess the potential of multiparametric chemical exchange saturation transfer magnetic resonance imaging (CEST MRI) for MCI detection. Twenty-eight patients with MCI and 31 age- and gender-matched normal controls (NCs) were enrolled. CEST MRI was performed with a gradient and spin-echo sequence on a 3T scanner. Multi-parametric CEST parameters were analyzed, such as amide CEST, amine CEST, amine and amide concentration independent assay (AACID), magnetization transfer ratio yielding rex (MTR_rex-amide), and downfield rNOE suppressed apparent exchange-dependent relaxation amide proton (DNS-AREX-amide). Statistical analyses of CEST parameters were performed to evaluate group differences, their correlations with Montreal cognitive assessment (MoCA) score, and diagnostic performance for MCI. Compared with NC group, amide CEST as well as MTR_rex-amide decreased in the left hippocampus and amine CEST as well as AACID increased in the right hippocampus in the MCI group; In both hippocampi, the DNS-AREX-amide were significantly lower in the MCI group versus the NC group (all P < 0.05). Amine CEST in the right hippocampus was negatively correlated with MoCA score (r = – 0.457, p = 0.017); DNS-AREX-amide in the bilateral hippocampus was positively correlated with MoCA score (left: r = 0.449, P = 0.019; right: AUC = 0.529, P = 0.05). DNS-AREX-amide in the bilateral hippocampus have a good ability to identify MCI (left: AUC = 0.756, P < 0.01; right: AUC = 0.762, P < 0.01). CEST MRI provides a potential imaging diagnostic strategy for MCI, which may promote early detection of MCI and provide novel insights into the pathological progress toward AD.

PMID:39648256 | DOI:10.1007/s11064-024-04307-5

Neurol Sci. 2024 Dec 9. doi: 10.1007/s10072-024-07920-y. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: The goal of this study was to assess the clinical profile of myasthenia gravis (MG) in patients diagnosed above 65-years of age (VLOMG) and identify clinical/serological parameters associated with their MG status and prognosis.

METHODS: This was a retrospective assessment of consecutive patients with VLOMG (n = 70) Demographics, clinical characteristics, medical comorbidities, the Myasthenia Gravis Foundation of America (MGFA) severity scale scores, and MGFA Post-Intervention Status (MGFA-PIS) were collected.

RESULTS: The research population was diagnosed with MG at an average age of 73.16 ± 6.33 years, a male/female ratio of 2.3/1 and a mean follow-up time of 53.09 ± 46.37 months. The titer of acetylcholine receptor antibodies (AChR Abs) was positive at 95.71% of patients. The predominant distribution of myasthenic weakness was oculobulbar (63.79%). At the last follow-up, 75.71% of patients reached Pharmacological-Remission (PR) or Minimal-Manifestations (MM), 17% manifested improvement and 7.14% were clinically unchanged, worse or dead, according to MGFA-PIS. Most patients responded to low doses of steroids. Males and patients with generalized muscle involvement upon disease-onset were more likely to reach PR or MM than females or ocular presentation (OR = 3.84 and O.18, respectively). Six patients (8.57%) were treated with at least one cycle of rituximab due to disease severity. Five (83%) reached PR or MM and one improved (mean follow up time: 7.5 months).

INTERPRETATION: We found that patients with VLOMG are usually males, with oculobulbar muscle involvement and positive titer of AChR Abs. The majority had a favorable prognosis and an adequate response to low doses of prednisolone and long-term immunosuppression.

PMID:39648250 | DOI:10.1007/s10072-024-07920-y

Signal Transduct Target Ther. 2024 Dec 9;9(1):345. doi: 10.1038/s41392-024-02047-0.

ABSTRACT

The large population of HER2-low breast cancer patients necessitates further research to provide enhanced clinical guidance. In this study, we retrospectively analyzed 1071 metastatic breast cancer (MBC) patients and the circulating tumor DNA (ctDNA) to investigate clinicopathological and genetic alterations of HER2-low MBC patients. The effect of HER2-low status on different treatment modalities was explored in two prospective clinical trials (NCT03412383, NCT01917279) and a retrospective study. Our findings suggest TP53, PIK3CA, and ESR1 are frequently mutated genes in HER2-low MBC. Compared to the HER2-0 group, mutations observed in the HER2-low group are more closely associated with metabolic pathway alterations. Additionally, among patients with ERBB2 mutations and treated with pyrotinib, the HER2-low group may experience superior prognosis when compared to the HER2-0 group. Notably, we did not find any statistically significant disparity in the response to chemotherapy, endocrine therapy, or CDK4/6 inhibitor therapy between HER2-0 and HER2-low breast cancer patients. Interestingly, within the subgroup of individuals with metabolic pathway-related gene mutations, we found that HER2-low group exhibited a more favorable response to these treatments compared to HER2-0 group. Additionally, dynamic analysis showed the HER2-low MBC patients whose molecular tumor burden index decreased or achieved early clearance of ctDNA after the initial two treatment cycles, exhibited prolonged survival. Moreover, we classified HER2-low MBC into three clusters, providing a reference for subsequent treatment with enhanced precision. Our study offers valuable insights into the biology of HER2-low MBC and may provide reference for personalized treatment strategies.

PMID:39648226 | DOI:10.1038/s41392-024-02047-0

Glob Health Res Policy. 2024 Dec 9;9(1):51. doi: 10.1186/s41256-024-00392-9.

ABSTRACT

BACKGROUND: Tuberculosis (TB) poses a significant social and economic burden to households of persons with TB (PwTB). Despite free diagnosis and care under the National TB Elimination Programme (NTEP), individuals often experience significant out-of-pocket expenditure and lost productivity, causing financial catastrophe. We estimated the costs incurred by the PwTB during TB care and identified the factors associated with the costs.

METHODS: In our cross-sectional study, we used multi-stage sampling to select PwTB notified under the NTEP, whose treatment outcome was declared between May 2022 and February 2023. Total patient costs were measured through direct medical, non-medical and indirect costs. Catastrophic costs were defined as expenditure on TB care > 20% of the annual household income. We determined the factors influencing the total cost of TB care using median regression. We plotted concentration curves to depict the equity in distribution of catastrophic costs across income quintiles. We used a cluster-adjusted, generalized model to determine the factors associated with catastrophic costs.

RESULTS: The mean (SD) age of the 1407 PwTB interviewed was 40.8 (16.8) years. Among them, 865 (61.5%) were male, and 786 (55.9%) were economically active. Thirty-four (2.4%) had Drug Resistant TB (DRTB), and 258 (18.3%) had been hospitalized for TB. The median (Interquartile range [IQR] and 95% confidence interval [CI]) of total costs of TB care was US$386.1 (130.8, 876.9). Direct costs accounted for 34% of the total costs, with a median of US$78.4 (43.3, 153.6), while indirect costs had a median of US$279.8 (18.9,699.4). PwTB < 60 years of age (US$446.1; 370.4, 521.8), without health insurance (US$464.2; 386.7, 541.6), and those hospitalized(US$900.4; 700.2, 1100.6) for TB experienced higher median costs. Catastrophic costs, experienced by 45% of PwTB, followed a pro-poor distribution. Hospitalized PwTB (adjusted prevalence ratio [aPR] = 1.9; 1.6, 2.2) and those notified from the private sector (aPR = 1.4; 1.1, 1.8) were more likely to incur catastrophic costs.

CONCLUSIONS: PwTB in India incur high costs mainly due to lost productivity and hospitalization. Nearly half of them experience catastrophic costs, especially those from poorer economic quintiles. Enabling early notification of TB, expanding the coverage of health insurance schemes to include PwTB, and implementing TB sensitive strategies to address social determinants of TB may significantly reduce catastrophic costs incurred by PwTB.

PMID:39648213 | DOI:10.1186/s41256-024-00392-9

High Blood Press Cardiovasc Prev. 2024 Dec 9. doi: 10.1007/s40292-024-00694-6. Online ahead of print.

ABSTRACT

INTRODUCTION: Abnormalities in total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) are each associated with increased cardiovascular risk, after adjusting for non-lipid risk factors. However, whether and to what extent the association for each lipid measure is confounded by other lipid measures is less understood.

AIM: This study aims to investigate the association of each lipid measure with cardiovascular and all-cause mortality while precluding the confounding caused by abnormalities in other lipid measures.

METHODS: The study utilized data from the third National Health and Nutrition Examination Survey (NHANES III, 1988-1994) and ten cycles of continuous NHANES (1999-2018). The study cohort included 23,761 participants who were 20 years or older, not pregnant, not receiving lipid-lowering treatment, and had complete data on all four lipid measures and mortality status. Participants were categorized into seven subgroups based on their lipid profiles. Kaplan-Meier survival curves and Cox proportional hazards models were used to examine the association between lipid abnormalities and mortality.

RESULTS: During a median follow-up of 140 months, 5,003 participants (14.1%) died, with 1,665 deaths (4.2%) attributable to cardiovascular causes. Compared with the reference group in which the four lipid measures were all normal, the subgroups with isolated high TC, two to three lipid abnormalities, and four lipid abnormalities were associated with increased risks for both cardiovascular and all-cause mortality in univariate analysis. However, only those with isolated high TC (for cardiovascular mortality, HR 1.52, 95% CI 1.13-2.06) and four lipid abnormalities (for all-cause mortality, HR 1.34, 95% CI 1.04-1.72) remained statistically significant after adjusting for non-lipid risk factors. Of note, compared with the reference group, the profile of non-lipid risk factors was apparently less favorable in the subgroup with two to three lipid abnormalities but similar (and some factors even more favorable) in the subgroup with isolated high TC. When the lipid measures were analyzed as continuous variables, a U-shaped relationship between HDL-C and mortality risk was observed for both cardiovascular and all-cause mortality, and very low LDL-C level was associated with increased mortality risk. No statistically significant association was found between TG levels and mortality risk.

CONCLUSION: Isolated high TC, very low LDL-C, and concurrent abnormalities in all four lipid measures were associated with increased mortality risk, whereas isolated high TG was not. A U-shaped relationship may exist between HDL-C level and mortality. Overall, these findings underscore the need for integrated management of dyslipidemia that takes all four lipid measures as well as non-lipid cardiovascular risk factors into account, particularly for those with concurrent abnormalities in two or more lipid measures.

PMID:39648198 | DOI:10.1007/s40292-024-00694-6