Tag: pubmed

AJNR Am J Neuroradiol. 2024 Aug 12:ajnr.A8441. doi: 10.3174/ajnr.A8441. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: In ischemic stroke, leptomeningeal collaterals can provide delayed and dispersed compensatory blood flow to tissue-at-risk despite an occlusion and can impact treatment response and infarct growth. The purpose of this work is to test the hypothesis that inclusion of this delayed and dispersed flow with an appropriately calculated Local Arterial Input Function (Local-AIF) is needed to quantify the degree of collateral blood supply in tissue distal to an occlusion.

MATERIALS AND METHODS: Seven experiments were conducted in a pre-clinical middle cerebral artery occlusion model. Dynamic susceptibility contrast MRI was imaged and post-processed to yield quantitative cerebral blood flow (qCBF) maps with both a traditionally chosen single arterial input function applied globally to the whole brain (i.e. “Global-AIF”) and a delay and dispersion corrected AIF (i.e. “Local-AIF”) that is sensitive to retrograde flow. Leptomeningeal collateral arterial recruitment was quantified with a pial collateral score from x-ray angiograms, and infarct growth calculated from serially acquired diffusion weighted MRI scans.

RESULTS: The degree of collateralization at x-ray correlated more strongly with qCBF using the Local-AIF in the ischemic penumbra (R²=0.81) than traditionally chosen Global-AIF (R²=0.05). qCBF using a Local-AIF was negatively correlated (less infarct progression as perfusion increased) with infarct growth (R² = 0.79) more strongly than a Global-AIF (R²=0.02).

CONCLUSIONS: In acute stroke, qCBF calculated with a Local-AIF is more accurate for assessing tissue status and collateral supply than traditionally chosen Global-AIFs. These findings support use of a Local-AIF that corrects for delayed and dispersed retrograde flow in determining quantitative tissue perfusion with collateral supply in occlusive disease.

ABBREVIATIONS: MRI = magnetic resonance imaging; DSC = dynamic susceptibility contrast; PCS = pial collateral score; MCAO = middle cerebral artery occlusion; MCA = middle cerebral artery; AIF = arterial input function; rCBF = relative cerebral blood flow; qCBF = quantitative cerebral blood flow.

PMID:39134367 | DOI:10.3174/ajnr.A8441

BMJ Glob Health. 2024 Aug 12;9(8):e015236. doi: 10.1136/bmjgh-2024-015236.

ABSTRACT

BACKGROUND: HIV testing and starting antiretroviral therapy (ART) are pivotal in treating people living with HIV (PLHIV) but sustaining PLHIV on treatment remains challenging. We assessed retention and attrition in community client-led antiretroviral distribution groups (CCLADs) in Uganda and identified positive deviant practices that foster long-term retention.

METHODS: Using explanatory mixed methods, we collected longitudinal medical data from 65 health facilities across 12 districts in East Central Uganda. Quantitative phase, from 18 April 2021 to 30 May 2021, employed survival analysis and Cox regression to assess retention and identify attrition risk factors. Qualitative inquiry focused on four districts with high attrition from 11 August 2021 to 20 September 2021, where we identified nine health facilities exhibiting high retention in CCLADs. We purposively selected 50 clients for in-depth interviews (n=22) or focus group discussions (n=28). Using thematic analysis, we identified positive deviant practices. We integrated quantitative and qualitative findings into joint displays.

RESULTS: Involving 3055 PLHIV, the study showed retention rates of 97.5% at 6 months, declining to 89.7% at 96 months. Attrition risk factors were lower levels of care (health centre three (adjusted HR (aHR) 2.80, 95% CI 2.00 to 3.65) and health centre four (aHR 3.61, 95% CI 2.35 to 5.54)); being unemployed (aHR 2.21, 95% CI 1.00 to 4.84); enrolment year into CCLAD (aHR 23.93, 95% CI 4.66 to 123.05) and virological failure (aHR 3.41, 95% CI 2.51 to 4.63). Of 22 clients interviewed, 8 were positive deviants. Positive deviants were characterised by prolonged retention in CCLADs, improved clinical outcomes and practised uncommon behaviours that enabled them to find better solutions than their peers. Positive deviant practices included fostering family-like settings, offering financial or self-development advice, and promoting healthy lifestyles.

CONCLUSIONS: Findings underscore the importance of addressing factors contributing to attrition and leveraging positive deviant practices to optimise retention and long-term engagement in HIV care.

PMID:39134343 | DOI:10.1136/bmjgh-2024-015236

BMJ Open Ophthalmol. 2024 Aug 12;9(1):e001732. doi: 10.1136/bmjophth-2024-001732.

ABSTRACT

BACKGROUND/AIMS: Population surveys are required to measure the prevalence of cataract blindness in the community. We conducted simultaneous surveys in two regions in Malaysia in 2023 to estimate the prevalence of untreated cataract, measure the visual outcomes after cataract surgery and compare the results with the survey in 2014.

METHODS: The surveys were done in Eastern and Sarawak administrative regions using the rapid assessment of avoidable blindness technique. It involved a multistage cluster sampling method, each cluster comprising 50 residents aged 50 years and older. The prevalence of cataract was determined through a visual acuity (VA) check and eye examination. The VA of those who had undergone cataract surgery was measured, and the findings were compared with the previous survey.

RESULTS: A total of 9709 subjects, 50 years old and older, were examined (percentages of response were 94.5% and 96.2% for Eastern and Sarawak, respectively). Comparing the current to the previous survey in 2014, the prevalence of cataract at all levels of surgical thresholds (except unilateral VA <6/60 and <6/18 in the Eastern) was reduced. The percentages of cataract surgery visual outcomes with good VA (6/12) were improved, and those with poor VA (<6/60) were reduced in both regions.

CONCLUSION: There was a reduction in cataract prevalence and improved visual outcomes in both regions. These favourable results could be attributed to the surgical performance monitoring initiatives and the community cataract programme implemented soon after the survey in 2014.

PMID:39134324 | DOI:10.1136/bmjophth-2024-001732

Photodiagnosis Photodyn Ther. 2024 Aug 10:104302. doi: 10.1016/j.pdpdt.2024.104302. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the correlations and consistency among the central corneal thickness (CCT) of healthy myopic patients measured with three different anterior segment analysis systems.

DESIGN: This was a retrospective study. The study included myopia patients who had undergone preoperative examinations in the refractive surgery department of our hospital between January 2021 and December 2023. The CCT was measured separately using Pentacam, Sirius, and IOLMaster 700.

METHODS: Statistical analysis was conducted using SPSS software. Correlations among the three groups of measured values were assessed using the Pearson method, and a simple scatter plot and fitting line were drawn. Bland‒Altman scatter plots and 95% limits of agreement (LoAs) were used to evaluate consistency in the data among the systems.

RESULTS: A total of 269 patients participated in the study, including 134 males (49.8%) and 135 females (50.2%). The CCT measurements by Pentacam, Sirius, and IOLMaster 700 instruments were found to be 541.63±31.67μm, 541.74±33.36μm, and 548.90±34.19μm respectively; significant differences were observed among these measurements (p<0.05). Significant differences were also observed in CCT between Pentacam and IOLMaster 700 as well as between Sirius and IOLMaster 700 (p<0.05). The CCT measurements by all three devices showed high positive correlation with all p values less than 0.001: Pentacam and Sirius, r=0.972; Pentacam and IOLMaster 700, r=0.966; and Sirius and IOLMaster 700, r=0.962. The respective 95% LoAs were -0.18∼0.18; -1.51∼-1.11; and -1.52∼-1.

CONCLUSION: The results indicate that there is a high correlation in measuring CCT for healthy myopic eyes using three different anterior segment analysis systems. However, the differences in the values measured by the three devices were statistically significant. Therefore, in actual clinical practice, it is suggested that the same device should be used to measureand evaluate the CCT across visits.

PMID:39134252 | DOI:10.1016/j.pdpdt.2024.104302

Bioresour Technol. 2024 Aug 10:131220. doi: 10.1016/j.biortech.2024.131220. Online ahead of print.

ABSTRACT

Addition of statistically optimized concentration of electron acceptor, propionic acid (1.2 g/L) at different cultivation times (0 h, 14.86 h and 19 h) during batch cultivation of B. thuringiensis in mixed substrate (glucose and glycerol) featured production of 8 g/L of biomass and 3.57 g/L of poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) containing 0.805 g/L of 3-Hydroxyvalerate concentration. Successful scale up of batch cultivation from 7 L to a 70 L bioreactor was, thereafter, achieved using power/volume (P/V) criteria with maximum PHBV and biomass concentration of 3.57 g/L and 7.15 g/L respectively. Characterization of PHBV so produced was carried out using NMR, FTIR, DSC and TGA to elucidate its structure, thermal properties and stability to map their applications in society. These findings highlight the potential of the optimized batch cultivation and scale-up process in producing PHBV emphasizing its relevance in sustainable biopolymer production.

PMID:39134246 | DOI:10.1016/j.biortech.2024.131220

Clin Chim Acta. 2024 Aug 10:119901. doi: 10.1016/j.cca.2024.119901. Online ahead of print.

ABSTRACT

BACKGROUND: Platelet contains growth factors that enhance tissue repair mechanisms, including epidermal growth factor (EGF), platelet-derived growth factor (PDGF-AA and -AB), and transforming growth factor (TGF)-β. Autologous platelet-rich plasma (PRP) has been shown to significantly improve the treatment of tendon injuries compared with hyaluronic acid and placebo. The topic of agreement between platelet concentrations and growth factors has been covered in some previous studies, but growth factor levels did not correlate well with platelet concentrations.

METHOD: In this study, autologous PRP was prepared by concentrating platelets through a J6-MI centrifuge. The automatic hematology analyzer Sysmex XN-20 was used to analyze the platelet concentration in PRP, and the PRP growth factors were determined by ELISA, including PDGF, transforming growth factor- β1 (TGF-β1), and EGF. Statistical analysis was conducted on data from 107 patients who received autologous PRP using Pearson correlation analysis.

RESULTS: Pearson correlation analysis revealed PDGF, TGF, and EGF had a strong positive correlation with the platelet concentration of the final PRP product (r = 0.697, p < 0.0001; r = 0.488, p < 0.0001; r = 0.572, p < 0.0001, respectively) CONCLUSIONS: There was a strong positive correlation between the concentration of platelets in the final PRP product and the levels of PDGF-AB, TGF-β, and EGF. These results suggested straightforward and cost-effective growth factor tests can provide valuable information about platelet content in PRP.

PMID:39134218 | DOI:10.1016/j.cca.2024.119901

Brain Stimul. 2024 Aug 10:S1935-861X(24)00139-6. doi: 10.1016/j.brs.2024.08.002. Online ahead of print.

ABSTRACT

BACKGROUND: Deep brain stimulation of central thalamus (CT-DBS) has potential for modulating states of consciousness, but it can also trigger electrographic seizures, including poly-spike-wave trains (PSWT).

OBJECTIVES: To report the probability of inducing PSWTs during CT-DBS in awake, freely-moving mice.

METHODS: Mice were implanted with electrodes to deliver unilateral and bilateral CT-DBS at different frequencies while recording EEG. We titrated stimulation current by gradually increasing it at each frequency until a PSWT appeared. Subsequent stimulations to test arousal modulation were performed at the current one step below the current that caused a PSWT during titration.

RESULTS: In 2.21% of the test stimulations (10 out of 12 mice), CT-DBS caused PSWTs at currents lower than the titrated current, at currents as low as 20 μA.

CONCLUSION: Our study found a small but significant probability of inducing PSWTs even after titration and at relatively low currents. EEG should be closely monitored for electrographic seizures when performing CT-DBS in both research and clinical settings.

PMID:39134207 | DOI:10.1016/j.brs.2024.08.002

Brain Behav Immun. 2024 Aug 10:S0889-1591(24)00539-7. doi: 10.1016/j.bbi.2024.08.017. Online ahead of print.

ABSTRACT

BACKGROUND: Childhood maltreatment (CM) has long-term consequences for the regulation of stress biology which are particularly pronounced when mental and physical health sequelae have manifested. C-reactive protein (CRP) has been shown to be elevated in the non-pregnant state in association with CM as well as in the setting of CM-associated mental and physical health sequelae. In pregnancy, however, the association between CM and CRP is less clear. We sought to examine this association and consider the moderating role of four common health sequelae of CM (maternal depressive symptoms, overweight/obesity, smoking, and hypertensive disorders during pregnancy).

METHODS: A prospective, longitudinal study of 744 healthy pregnant participants was conducted, with analyses focusing on a sample of 643 participants. CM was assessed with the Childhood Trauma Questionnaire (CTQ) and categorized by whether no vs. one or more moderate to severe CM experiences were reported. Blood serum concentrations of CRP, maternal depression severity (continuous scores of the Center for Epidemiologic Studies Depression Scale, CES-D) and smoking during pregnancy were assessed in early (16.52 ± 2.50 weeks gestation) and late (33.65 ± 1.18 weeks gestation) pregnancy. Pre-pregnancy body mass index (BMI) was obtained at the first study visit and hypertensive disorders diagnosed during pregnancy were obtained from the medical record. Linear mixed effects models were employed to assess main effects of CM as well as interactive effects of CM and four common CM-associated sequelae as well as a sum score of these sequelae on repeatedly measured CRP concentration. In secondary analyses, we conducted latent class analyses to classify participants based on their specific experiences of childhood abuse and/or neglect and to assess the association of these CM subgroups with CM sequelae and CRP. All analyses were adjusted for potential confounders (maternal race and ethnicity and education/income).

RESULTS: CRP concentration decreased from early to late pregnancy (B = -0.06, SE = 0.01, p < 0.001). While there was no main effect of CM on CRP (p = 0.49), the interaction of CM and depressive symptoms was associated with CRP concentration (B = 0.08, SE = 0.04, p < 0.05), indicating higher CRP across pregnancy with increasing levels of depressive symptoms during pregnancy in participants with CM experience. This interaction was mainly driven by participants with co-occurring physical and emotional maltreatment. For none of the other CM-associated sequelae a statistically significant interaction with CM on CRP concentration was observed.

CONCLUSIONS: These results add to the growing empirical evidence suggesting higher inflammation during pregnancy in participants exposed to CM who experience depressive symptoms and highlight the detrimental effects of multiple co-occurring experiences of maltreatment. Given the negative consequences of chronic inflammatory state for the mother and the developing fetus, monitoring and treating psychiatric sequelae during pregnancy among participants exposed to CM is potentially an important opportunity to dampen long-term detrimental effects of CM, serving at least two generations.

PMID:39134185 | DOI:10.1016/j.bbi.2024.08.017

Chest. 2024 Aug 10:S0012-3692(24)04904-3. doi: 10.1016/j.chest.2024.07.160. Online ahead of print.

ABSTRACT

BACKGROUND: Latino adults experience multiple barriers to healthcare access and treatment that result in tobacco-related disparities. Mobile interventions have the potential to deliver smoking cessation treatment among Latino adults, the highest users of mobile technologies.

RESEARCH QUESTION: Is Decídetexto, a culturally accommodated mobile health intervention, more effective for smoking cessation compared to standard care among Latino adults who smoke?

STUDY DESIGN AND METHODS: A two-arm parallel group randomized clinical trial (RCT) was conducted in Kansas, New Jersey, and New York between October 2018 and September 2021. Eligible Latino adults who smoke (n=457) were randomly assigned to Decídetexto or a standard care group. The primary outcome was biochemically verified 7-day smoking abstinence at week 24. Secondary outcomes included self-reported 7-day smoking abstinence at weeks 12 and 24, and uptake and adherence of nicotine replacement therapy (NRT).

RESULTS: Participants mean age was 48.7 (SD 11.1) years, 45.2% were female, and 50.3% smoked ≥10 cigarettes per day. Two hundred twenty-nine participants were assigned to Decídetexto and 228 to standard care. Treating those lost to follow-up as participants who continued smoking, 14.4% of participants in the Decídetexto group were biochemically verified abstinent at week 24 compared to 9.2% in the standard care group (OR 1.66 [95% CI, 0.93-2.97], p=0.09). Treating those lost to follow-up as participants who continued smoking, 34.1% of the participants in the Decídetexto group self-reported smoking abstinence at week 24 compared to 20.6% of participants in the standard care group (OR 1.99 [95%, 1.31-3.03]; p<0.001). Analyzing only participants who completed the assessment at week 24, 90.6% (174/192) of participants in the Decídetexto group self-reported using NRT for at least one day compared to 70.2% (139/198) of participants in standard care (OR 4.10 [95% CI, 2.31-7.28]; p<0.01).

INTERPRETATION: Among Latino adults who smoke, the Decídetexto intervention was not associated with a statistically significant increase in biochemically verified abstinence at week 24. However, the Decídetexto intervention was associated with a statistically significant increase in self-reported 7-day smoking abstinence at weeks 12 and 24, and uptake of NRT. This RCT provides encouragement for the use of Decídetexto for smoking cessation among Latino adults.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03586596.

PMID:39134144 | DOI:10.1016/j.chest.2024.07.160

J Acad Nutr Diet. 2024 Aug 10:S2212-2672(24)00751-2. doi: 10.1016/j.jand.2024.08.001. Online ahead of print.

ABSTRACT

BACKGROUND: The 2020-2025 Dietary Guidelines for Americans (DGA) includes a lacto-ovo vegetarian pattern (the Healthy Vegetarian Dietary Pattern; HVDP) as one recommended dietary patterns during pregnancy.

OBJECTIVE: To adapt the HVDP for vegan, ovo-vegetarian, lacto-vegetarian, and pescatarian diets during pregnancy.

DESIGN: Using food pattern modeling, four adaptations of the HVDP were developed at energy levels that may be appropriate during pregnancy (1800, 2000, 2200, 2400, and 2600 kcal/day). Models were run both with and without the addition of a composite prenatal supplement.

MAIN OUTCOME MEASURES: Main outcome measures were macro- and micronutrient adequacy without exceeding recommendations for saturated fat and added sugar.

STATISTICAL ANALYSIS PERFORMED: The 2020-2025 DGA Food Pattern Modeling Report was used to define food groups and nutrients in the HVDP. The HVDP was revised to remove dairy and/or eggs or to add seafood.

RESULTS: Across all examined energy levels (1800, 2000, 2200, 2400, and 2600 kcal per day), modeled dietary patterns provided sufficient macronutrients. Without prenatal supplements, each dietary pattern met most, but not all, micronutrient recommendations. Micronutrients that were below recommendations in patterns without supplements included vitamin D, iron, vitamin E, sodium, and choline. With the addition of an “composite” prenatal supplement to these patterns, the nutrients below 100% of recommendations were vitamin D, choline, and sodium.

CONCLUSIONS: Overall, these results show that a HVDP and similar diets without meat, eggs, dairy, and/or seafood can provide most nutrients needed during pregnancy, albeit with some micronutrient challenges similar to those diets that include meat and other animal products.

PMID:39134141 | DOI:10.1016/j.jand.2024.08.001