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Nevin Manimala Statistics

IL-6 and hsCRP predict cardiovascular mortality in patients with heart failure with preserved ejection fraction

ESC Heart Fail. 2024 Jul 14. doi: 10.1002/ehf2.14959. Online ahead of print.

ABSTRACT

AIMS: Inflammation accompanies heart failure (HF) and elevated levels of inflammatory biomarkers are linked to new onset of HF. However, whether the prognostic relevance of inflammatory biomarkers is different in HF with reduced (HFrEF) and preserved ejection fraction (HFpEF) is unclear. The aim of the current study is to explore the role of inflammation on the mortality risk in patients with HF.

METHODS: We analysed interleukin-6 and hsCRP levels by ELISA and immunonephelometry, respectively, in HFpEF and HFrEF patients referred for coronary angiography and assessed the prognostic value in the Ludwigshafen Risk and Cardiovascular Health (LURIC) study.

RESULTS: HF was present in 1086 patients (N = 506 HFpEF; N = 580 HFrEF; mean age 65 ± 10 years; 28% female). Increasing IL-6 levels were significantly associated with increased CV mortality in HFpEF [1.5 (95% CI: 1.1-2.2), P = 0.018] but not HFrEF [HR 1.3 (95% CI: 1.0-1.7), P = 0.06] patients. High-sensitive CRP followed a similar pattern but failed to reach statistical significance after full-adjustment (HFpEF: HR 1.4 95%C I: 1.0-2.0; P = 0.065; HFrEF HR: 1.0 95% CI: 0.7-1.3; P = 0.800). Interaction analysis in patients stratified by IL-6 and N terminal pro brain natriuretic peptide (NT-proBNP) above and below the median revealed a stepwise increase in CV-mortality in HFpEF (P = 0.036) but not HFrEF patients (P = 0.220). To investigate the relationship between IL-6 and NT-proBNP, we assessed the genetic IL6-Receptor variant p.Asp358Ala (rs2228145) which is linked to impaired IL-6 receptor signalling. Homozygous carriers with HFpEF but not HFrEF exhibited significantly lower NT-pro-BNP levels compared with wildtype carriers (HFpEF 779 pg/mL ± 787 vs. 1180 pg/ mL ± 1532; P = 0.008; HFrEF 2289 pg/ mL ± 3439 vs. 2326 pg/ mL ± 3386; P = 0.94), raising the hypothesis that IL-6 signalling may play a pathophysiological role in HFpEF.

CONCLUSIONS: These data suggest a predictive value of elevated IL-6 for CV-mortality in HFpEF but not in HFrEF patients.

PMID:39003598 | DOI:10.1002/ehf2.14959

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Nevin Manimala Statistics

Evaluating artificial intelligence-enhanced digital urine cytology for bladder cancer diagnosis

Cancer Cytopathol. 2024 Jul 14. doi: 10.1002/cncy.22884. Online ahead of print.

ABSTRACT

BACKGROUND: This study evaluated the diagnostic effectiveness of the AIxURO platform, an artificial intelligence-based tool, to support urine cytology for bladder cancer management, which typically requires experienced cytopathologists and substantial diagnosis time.

METHODS: One cytopathologist and two cytotechnologists reviewed 116 urine cytology slides and corresponding whole-slide images (WSIs) from urology patients. They used three diagnostic modalities: microscopy, WSI review, and AIxURO, per The Paris System for Reporting Urinary Cytology (TPS) criteria. Performance metrics, including TPS-guided and binary diagnosis, inter- and intraobserver agreement, and screening time, were compared across all methods and reviewers.

RESULTS: AIxURO improved diagnostic accuracy by increasing sensitivity (from 25.0%-30.6% to 63.9%), positive predictive value (PPV; from 21.6%-24.3% to 31.1%), and negative predictive value (NPV; from 91.3%-91.6% to 95.3%) for atypical urothelial cell (AUC) cases. For suspicious for high-grade urothelial carcinoma (SHGUC) cases, it improved sensitivity (from 15.2%-27.3% to 33.3%), PPV (from 31.3%-47.4% to 61.1%), and NPV (from 91.6%-92.7% to 93.3%). Binary diagnoses exhibited an improvement in sensitivity (from 77.8%-82.2% to 90.0%) and NPV (from 91.7%-93.4% to 95.8%). Interobserver agreement across all methods showed moderate consistency (κ = 0.57-0.61), with the cytopathologist demonstrating higher intraobserver agreement than the two cytotechnologists across the methods (κ = 0.75-0.88). AIxURO significantly reduced screening time by 52.3%-83.2% from microscopy and 43.6%-86.7% from WSI review across all reviewers. Screening-positive (AUC+) cases required more time than negative cases across all methods and reviewers.

CONCLUSIONS: AIxURO demonstrates the potential to improve both sensitivity and efficiency in bladder cancer diagnostics via urine cytology. Its integration into the cytopathological screening workflow could markedly decrease screening times, which would improve overall diagnostic processes.

PMID:39003588 | DOI:10.1002/cncy.22884

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Nevin Manimala Statistics

Evaluation of a flow cytometry-based method for determination of T-lymphocyte subtypes for quality assessment of cell therapy products

Scand J Clin Lab Invest. 2024 Jul 14:1-5. doi: 10.1080/00365513.2024.2377961. Online ahead of print.

ABSTRACT

Chimeric antigen receptor-T (CAR-T) cell therapy is currently the best-known type of immune effector cells therapy. For CAR T-cell therapy, the determination of CD3+ T cells is necessary for the quality control of fresh leukapheresis product as starting material. The aim was to validate analytical method for quantification of percentage and absolute count of T lymphocyte subtypes (CD3+, CD4+ and CD8+ cells) in fresh apheresis products using single-platform method on flow cytometer BD FACS Canto II. Validation study included determination of precision, trueness (bias), assessment of linearity, carryover, comparison of results obtained with two different protocols on flow cytometer for CD3+ cells determination and stability study. For between-run precision coefficients of variation (CVs) were <20%, as well as bias for all T-lymphocyte subtypes. For within-run precision, CVs were <10%, except for low CD8+ cell (percentage 10.51% and viable absolute count 12.37%). Comparison of results obtained with two different protocols for CD3+ cells determination shows no statistically significant difference. Statistically significant differences between results of the analysis of CD4+ cells in fresh samples and results obtained after storage at 4 °C (p = .004) and at room temperature (p = .018) were found. In conclusion, method for enumeration of T-lymphocyte subtypes can be used in routine work on BD FACS Canto II instrument for quality assessment of fresh cell products collected by leukapheresis procedure.

PMID:39003578 | DOI:10.1080/00365513.2024.2377961

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Nevin Manimala Statistics

Radiographic evaluation of the forelimb bone development in maned wolves (Chrysocyon brachyurus)

Anat Histol Embryol. 2024 Jul;53(4):e13091. doi: 10.1111/ahe.13091.

ABSTRACT

This study aimed to assess the fusion of growth plates and the development of secondary ossification centres in the forelimb bones of maned wolves (Chrysocyon brachyurus), contrasting the findings with established data from domestic dogs. Three maned wolves, comprising one male and two females, initially aged between 3 and 4 months, were subjected to monthly radiographic evaluations until 10-11 months of age, followed by bimonthly assessments until 18-19 months of age, encompassing both forelimbs. The closure times of growth plates were observed as follows: supraglenoid tubercle (7-8 months), proximal humerus (17-19 months), distal humerus (8-9 months), medial epicondyle of the humerus (8-9 months), proximal ulna (9-10 months), proximal radius (13-15 months), distal ulna (13-15 months) and distal radius (17-19 months). Statistical analysis revealed significant differences in the areas of secondary ossification centres in the proximal epiphyses of the humerus and radius, respectively, observed from the initial evaluation at 8-9 months and 6-7 months. Conversely, the epiphyses of the supraglenoid tubercle, distal humerus, proximal ulna, distal ulna, medial epicondyle of the humerus and distal radius did not exhibit significant area differences between 3-4 months and 4-5 months, yet notable distinctions emerged at 5-6 months. In summary, while the radiographic appearance of epiphyseal growth plates and secondary ossification centres in maned wolves resembles that of domestic dogs, closure times vary. These findings contribute to understanding the dynamics of epiphyseal growth plates in this species.

PMID:39003574 | DOI:10.1111/ahe.13091

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Nevin Manimala Statistics

Arkady Mihailovich Merkov (1899-1971): to the 125th Anniversary

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2024 May;32(3):495-498. doi: 10.32687/0869-866X-2024-32-3-495-498.

ABSTRACT

The article takes up scientific, teaching and organizational activities of Arkady Mikhailovich Merkov, professor and doctor of medical sciences. A. M. Merkov is prominent specialist in the field of social hygiene and health care organization. He is author of about 200 works, including 23 monographs devoted to sanitary and demographic statistics and statistics of malignant neoplasms.

PMID:39003561 | DOI:10.32687/0869-866X-2024-32-3-495-498

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Nevin Manimala Statistics

The venereal morbidity in Russia in 1914-1924

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2024 May;32(3):484-489. doi: 10.32687/0869-866X-2024-32-3-484-489.

ABSTRACT

It is accepted to explain increasing of venereal diseases during years of the Revolution by degradation of morality and general disorder of system of state administration and sanitary services in Russia. The cross-verification of information presented in scientific publications and primary information sources makes it possible to look into following issues: degree of venereal (syphilitic) contamination of population of pre-revolutionary Russia; influence on sanitary statistics by erroneous diagnostics and convictions of Zemstvo medicine about predominantly non-sexual path of transmission of syphilis pathogen in Russian countryside; dynamics and sources of venereal morbidity in wartime. The high indicators of pre-revolutionary statistics of venereal infections could be affected by diagnostic errors. The “village syphilis” encountered in public milieu could be completely different disease not sexually transmitted and not chronic form of disease. The primary documents allow to discuss increasing of the number of venereal patients during war years, that however, does not reach catastrophic numbers that can be found even in scientific publications. This is also confirmed by data of Chief Military Sanitary Board of the Red Army for 1920s and statistical materials of People’s Commissariat of Health Care of the RSFSR. The high morbidity was demonstrated by same Gubernias that were problematic before the Revolution and only later by those ones through which during the war years passed army masses. In Russia, total level of syphilis morbidity after the end of Civil War occurred to be more than twice lower than in pre-war 1913 and continued to decrease under impact of sanitary measures of Soviet public health.

PMID:39003559 | DOI:10.32687/0869-866X-2024-32-3-484-489

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Nevin Manimala Statistics

The readiness of Kazakhstan to implementation of medicinal insurance: the sociological substantiation and education activities of public organizations

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2024 May;32(3):456-461. doi: 10.32687/0869-866X-2024-32-3-456-461.

ABSTRACT

Until recently, in Kazakhstan, both health care services and medication support of population were financed from National budget and compulsory social health insurance foundation. But actual system meet needs of Kazakhstanis in medications not in full measure. The purpose of the study is to identify readiness of citizens to implementation of new medicinal insurance program with state co-financing. The study was carried out in 2022 in 17 regions of Kazakhstan. The readiness of Kazakhstanis to participate in medicinal insurance program with state co-financing was studied through sociological survey of 5 819 Kazakhstanis. The sociological survey revealed that respondents express average degree of readiness to implementation of new medicinal insurance program with state co-financing and to purchasing of insurance policy. The correlation between social demographic characteristics (objective indicators) and readiness indicator (subjective indicator) was revealed. The younger males with higher education, residing in urban areas, with average and high income and officially married are more inclined to purchase insurance policy. At that, according to results of sociological survey, one third of respondents have no relevant information about health insurance in general and medicinal insurance in particular. They found it difficult to express their personal position about this issues. It is supposed that Kazakhstanis in the result of educational measures will take part in medicinal insurance program with state co-financing. The education projects can be implemented through public organizations operating locally and communicating with population at the micro level. It is determined that it is especially important to apply educational measures to rural residents, middle-aged and elderly people, females and persons with low average income per family member.

PMID:39003554 | DOI:10.32687/0869-866X-2024-32-3-456-461

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Nevin Manimala Statistics

The analysis of demand in pathoanatomists applying staff standards

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2024 May;32(3):445-451. doi: 10.32687/0869-866X-2024-32-3-445-451.

ABSTRACT

The objective analysis of state of medical personnel, along with assessment of real need for specialists, is the basis of improving activities of any health care service. In relation to pathologists, there is unique opportunity to perform similar analysis, based on application of current corresponding staff standards that consider volume of workload of physicians in order to determine required number of positions. The implementation of corresponding original methodology permitted to establish that the actual number of staff positions of pathologists in 2022 amounted up to average 40.6% of the number required according to staffing standards in the Irkutsk Oblast. The physician staffing ratio, calculated on the basis of required number of positions found according to proposed methodology, decreases to 29.1% and staffing with physicians excluding combined jobs to 17.1%. At that, implemented workload per one pathologist reaches 5.9 of standard positions. The deficiency of representatives of this specialty in the region, even if current combined jobs ratio is maintained, is 154 specialists.

PMID:39003553 | DOI:10.32687/0869-866X-2024-32-3-445-451

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Nevin Manimala Statistics

DNA Methylation-derived biological age and long-term mortality risk in subjects with type 2 diabetes

Cardiovasc Diabetol. 2024 Jul 13;23(1):250. doi: 10.1186/s12933-024-02351-7.

ABSTRACT

BACKGROUND: Individuals with type 2 diabetes (T2D) face an increased mortality risk, not fully captured by canonical risk factors. Biological age estimation through DNA methylation (DNAm), i.e. the epigenetic clocks, is emerging as a possible tool to improve risk stratification for multiple outcomes. However, whether these tools predict mortality independently of canonical risk factors in subjects with T2D is unknown.

METHODS: Among a cohort of 568 T2D patients followed for 16.8 years, we selected a subgroup of 50 subjects, 27 survived and 23 deceased at present, passing the quality check and balanced for all risk factors after propensity score matching. We analyzed DNAm from peripheral blood leukocytes using the Infinium Human MethylationEPIC BeadChip (Illumina) to evaluate biological aging through previously validated epigenetic clocks and assess the DNAm-estimated levels of selected inflammatory proteins and blood cell counts. We tested the associations of these estimates with mortality using two-stage residual-outcome regression analysis, creating a reference model on data from the group of survived patients.

RESULTS: Deceased subjects had higher median epigenetic age expressed with DNAmPhenoAge algorithm (57.49 [54.72; 60.58] years. vs. 53.40 [49.73; 56.75] years; p = 0.012), and accelerated DunedinPoAm pace of aging (1.05 [1.02; 1.11] vs. 1.02 [0.98; 1.06]; p = 0.012). DNAm PhenoAge (HR 1.16, 95% CI 1.05-1.28; p = 0.004) and DunedinPoAm (HR 3.65, 95% CI 1.43-9.35; p = 0.007) showed an association with mortality independently of canonical risk factors. The epigenetic predictors of 3 chronic inflammation-related proteins, i.e. CXCL10, CXCL11 and enRAGE, C-reactive protein methylation risk score and DNAm-based estimates of exhausted CD8 + T cell counts were higher in deceased subjects when compared to survived.

CONCLUSIONS: These findings suggest that biological aging, as estimated through existing epigenetic tools, is associated with mortality risk in individuals with T2D, independently of common risk factors and that increased DNAm-surrogates of inflammatory protein levels characterize deceased T2D patients. Replication in larger cohorts is needed to assess the potential of this approach to refine mortality risk in T2D.

PMID:39003492 | DOI:10.1186/s12933-024-02351-7

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Foraging for the future: traditional culinary uses of wild plants in the Western Himalayas-Kashmir Valley (India)

J Ethnobiol Ethnomed. 2024 Jul 13;20(1):66. doi: 10.1186/s13002-024-00707-7.

ABSTRACT

BACKGROUND: In the intricate tapestry of food security, wild food species stand as pillars, nourishing millions in low-income communities, and reflecting the resilience and adaptability of human societies. Their significance extends beyond mere sustenance, intertwining with cultural traditions and local knowledge systems, underscoring the importance of preserving biodiversity and traditional practices for sustainable livelihoods.

METHODS: The present study, conducted between February 2022 and August 2023 along the Line of Control in India’s Kashmir Valley, employed a rigorous data collection encompassing semi-structured interviews, focus group discussions, and specific field observations facilitated through a snowball sampling technique.

RESULTS AND DISCUSSION: The comprehensive inventory includes 108 edible plant and fungal species from 48 taxonomic families, with Rosaceae (N = 11) standing out. Young and soft leaves (N = 60) are an important component of various culinary preparations, with vegetables (N = 65) being the main use, followed by fruits (N = 19). This use is seasonal, with collection peaks in March-April and June-August (N = 12). The study also highlights the importance of use value (UV), with Portulaca oleracea standing out as the plant taxon (UV = 0.61), while Asyneuma thomsoni has the lowest use value (UV = 0.15). Many species such as Senecio chrysanthemoides, Asperugo procumbens, Asyneuma thomsoni, and Potentilla nepalensis were classified as new for gastronomic use. Furthermore, the study underlines the great cultural importance of mushrooms such as Morchella esculenta and Geopora arenicola in influencing social hierarchies within the community. However, the transmission of traditional knowledge across generations is declining in the region. At the same time, the conservation of endangered plant species on the IUCN Red List, such as Trillium govanianum, Taxus wallichiana, Saussurea costus, and Podophyllum hexandrum, requires immediate attention.

CONCLUSION: Conservation measures should be prioritized, and proactive remedial action is needed. Further research into the nutritional value of these edible species could pave the way for their commercial cultivation, which would mean potential economic growth for local communities, make an important contribution to food security in the area under study, and contribute to scientific progress.

PMID:39003490 | DOI:10.1186/s13002-024-00707-7