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Nevin Manimala Statistics

Prevalence and genetic diversity of Blastocystis sp. among autochthonous and immigrant patients in Italy

Microb Pathog. 2023 Oct 13:106377. doi: 10.1016/j.micpath.2023.106377. Online ahead of print.

ABSTRACT

The prevalence of Blastocystis sp., its genetic diversity and the distribution of circulating subtypes (STs) were molecularly investigated in a cohort of autochthonous and immigrant patients with gastrointestinal symptoms hospitalized over the period February 2022-June 2023 at the Policlinico Ospedaliero-Universitario “Riuniti”, Foggia, in Southern Italy. The population variables, including patient geographical origin, gender and age classes were reported. Out of the 927 investigated patients, 36 (3.9%) were positive for Blastocystis sp. A statistically significant association with African origin and age classes >18 years old was found. ST1 (allele 4), ST2 (alleles 9, 13), ST3 (alleles 34, 36) and ST4 (allele 92) were the subtypes detected with a different distribution between autochthonous and immigrant patients. Co-infections with enteric protozoa such as Giardia duodenalis and Dientamoeba fragilis, pathogenic bacteria as Clostridioides difficile, Campylobacter jejuni and Aeromonas sp. and viral infections such as Norovirus were found in 33% of cases. This is the first study of Blastocystis sp., its circulating subtypes and allele variability among patients with different geographical origin in an area of Southern Italy, in the Central Mediterranean, characterized by high immigrant pressure. These results provide baseline data to better investigate a potential interaction between Blastocystis sp. and other risk factors in patients with gastrointestinal symptoms.

PMID:37839760 | DOI:10.1016/j.micpath.2023.106377

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Nevin Manimala Statistics

Developing an exclusive sensor based on molecularly imprinted polymer/Multi-walled carbon nanotubes/Fe3O4@Au nanocomposite for the selective determination of an anti-cancer drug imatinib

Chemosphere. 2023 Oct 13:140450. doi: 10.1016/j.chemosphere.2023.140450. Online ahead of print.

ABSTRACT

Determination of pharmaceuticals especially anticancer drugs is one of the important issues in environmental and medical investigation and creating good information about human health. The presence sturdy introducing an electroanalytical sensor based on molecularly imprinted polymer (MIP)/Multi-walled carbon nanotubes (MWCNTs)/Au@Fe3O4 nanoparticles modified carbon paste electrode (PE) to determine imatinib (IMA). The MIP/MWCNTs/Au@Fe3O4/PE showed catalytic activity and also a sensitive strategy to sensing IMA in the concentration range 1-1000 μM with a limit of detection of 0.013 μM. The MIP/MWCNTs/Au@Fe3O4/PE has shown interesting results in the analysis of IMA in real samples, and the interference investigations results show the high selectivity of the MIP/MWCNTs/Au@Fe3O4/PE in the monitoring of IMA in complex fluids such as tablet and blood serum and results approved by F-test and t-test as statistical methods.

PMID:37839746 | DOI:10.1016/j.chemosphere.2023.140450

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Nevin Manimala Statistics

The indocyanine green clearance test as a predictor for linezolid overexposure in septic patients

Int J Antimicrob Agents. 2023 Oct 13:107006. doi: 10.1016/j.ijantimicag.2023.107006. Online ahead of print.

ABSTRACT

Hepatic impairments increase the risk of drug overexposure in septic patients. However, there is a lack of effective indicators to predict overexposure risks. The indocyanine green (ICG) clearance test is a helpful method for dynamically assessinghepatic function and perfusion. The objective of this study was to investigate whether the ICG test could serve as a potential predictor of the linezolid trough concentration (Cmin), and we compared its efficacy with that of conventional liver function markers. Thirty-five consecutive septic patients treated with linezolid were subgrouped into either linezolid Cmin≤7μg/mL or linezolid Cmin>7μg/mL. Correlations between the linezolid Cmin and ICG-PDR (plasma disappearance rate), ICG-R15 (retention ratio after 15 minutes), and other traditional indicators were analyzed by the Spearman’s rank test. We employed a multivariable regression model to discern factors contributing independently to overexposure. Statistical differences were observed between groups for the acute physiology and chronic health evaluation (APACHE) II score (p=0.031), sepsis organ failure assessment (SOFA) score (p=0.018), creatinine clearance rate(CCR) (p=0.003), thrombocytes (p=0.039), lactate (p=0.003), ICG-PDR (p<0.001), and ICG-R15 (p<0.001). Moreover, linezolid Cminwas correlated with ICG-PDR (rho=-0.628, p<0.001), ICG-R15 (rho= 0.676, p<0.001), and CCR (rho=-0.503, p=0.002). We identified ICG-PDR as an independent predictor of linezolid overexposure, with an optimal cut-off value of 17.70%/minute (93.3% sensitivity, 85.0% specificity, p < 0.001). This pilot clinical trial represents the first investigation of the potential of the ICG test to predict linezolid overexposure in septic patients.

PMID:37839718 | DOI:10.1016/j.ijantimicag.2023.107006

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Nevin Manimala Statistics

Effect of Motion State Variability on Error-related Potentials during Continuous Feedback Paradigms and Their Consequences for Classification

J Neurosci Methods. 2023 Oct 13:109982. doi: 10.1016/j.jneumeth.2023.109982. Online ahead of print.

ABSTRACT

BACKGROUND: An erroneous motion would elicit the error-related potential (ErrP) when humans monitor the behavior of the external devices. This EEG modality has been largely applied to brain-computer interface in an active or passive manner with discrete visual feedback. However, the effect of variable motion state on ErrP morphology and classification performance raises concerns when the interaction is conducted with continuous visual feedback.

NEW METHOD: In the present study, we designed a cursor control experiment. Participants monitored a continuously moving cursor to reach the target on one side of the screen. Motion state varied multiple times with two factors: (1) motion direction and (2) motion speed. The effects of these two factors on the morphological characteristics and classification performance of ErrP were analyzed. Furthermore, an offline simulation was performed to evaluate the effectiveness of the proposed extended ErrP-decoder in resolving the interference by motion direction changes.

RESULTS: The statistical analyses revealed that motion direction and motion speed significantly influenced the amplitude of feedback-ERN and frontal-Pe components, while only motion direction significantly affected the classification performance.

COMPARISON WITH EXISTING METHODS: Significant deviation was found in ErrP detection utilizing classical correct-versus-erroneous event training. However, this bias can be alleviated by 16% by the extended ErrP-decoder.

CONCLUSION: The morphology and classification performance of ErrP signal can be affected by motion state variability during continuous feedback paradigms. The results enhance the comprehension of ErrP morphological components and shed light on the detection of BCI’s error behavior in practical continuous control.

PMID:37839711 | DOI:10.1016/j.jneumeth.2023.109982

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Nevin Manimala Statistics

Transcatheter Vacuum-Assisted Mass Extraction versus Surgical Debridement for Vegetations in Tricuspid Valve Infective Endocarditis: A Meta-Analysis of Observational Studies

Am J Cardiol. 2023 Oct 13:S0002-9149(23)01155-4. doi: 10.1016/j.amjcard.2023.10.021. Online ahead of print.

ABSTRACT

Tricuspid valve infective endocarditis (TVIE), often associated with vegetation in people who inject drugs, has introduced a less invasive option for vegetation removal: transcatheter vacuum-assisted mass extraction (TVME). This technique is emerging as an alternative to standard surgical debridement (SD) and valve repair. However, the comparative effectiveness of TVME versus SD in treating TVIE has yet to be investigated. A comprehensive systematic literature search was performed on PUBMED, EMBASE, and COCHRANE to identify all relevant studies comparing TVME with SD in patients with TVIE. The search covered studies from inception up to August 15, 2023. For data analysis, Review Manager (RevMan) 5.4 software was employed, using a random-effects model to calculate risk ratios (RR), mean differences, and 95% confidence intervals (CI). Five studies included a total of 431 patients (244 in the TVME arm and 187 in the SD arm). In-hospital mortality (p=0.72), procedural mortality (p=0.77), 30-day mortality (p=0.25), and 1-year mortality (p=0.44) insignificantly favored SD over TVME. Overall mortality across the five studies insignificantly favored TVME over SD (RR=0.66, 95% CI 0.31-1.39, p=0.27, I2=57%). When addressing heterogeneity by excluding one study, no statistical significance in the difference between the two arms regarding overall mortality was observed (RR 0.99, 95% CI 0.60-1.63, p=0.97, I2=0%). This meta-analysis of the five observational studies found no significant difference in overall mortality between TVME and SD for the treatment of TVIE. However, prospective randomized controlled trials are necessary to further understand and compare the outcomes of these two approaches.

PMID:37839690 | DOI:10.1016/j.amjcard.2023.10.021

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Nevin Manimala Statistics

Comparative Safety and Effectiveness of Warfarin or Rivaroxaban Versus Apixaban in Patients With Advanced CKD and Atrial Fibrillation: Nationwide US Cohort Study

Am J Kidney Dis. 2023 Oct 13:S0272-6386(23)00859-4. doi: 10.1053/j.ajkd.2023.08.017. Online ahead of print.

ABSTRACT

RATIONALE & OBJECTIVE: Head-to-head data comparing the effectiveness and safety of oral anticoagulants in patients with atrial fibrillation (AF) and advanced CKD are lacking. We compared the safety and effectiveness of warfarin or rivaroxaban vs. apixaban in patients with AF and non-dialysis CKD stages 4-5.

STUDY DESIGN: Propensity score matched cohort study.

SETTING: & Participants: Two nationwide U.S. claims databases, Medicare and Optum’s de-identified Clinformatics® Data Mart Database (01/01/2013-03/31/2022). New initiators of warfarin vs. apixaban (N = 12,488) and rivaroxaban vs. apixaban (N = 5720) with nonvalvular AF and CKD stage 4-5.

EXPOSURES: Warfarin, rivaroxaban or apixaban.

OUTCOMES: Primary outcomes included major bleeding and ischemic stroke. Secondary outcomes included all-cause mortality, major gastrointestinal bleeding, and intracranial bleeding.

ANALYTICAL APPROACH: Cox regression was used to estimate hazard ratios (HR) and 1:1 propensity score matching was used to adjust for 80 potential confounders.

RESULTS: Compared with apixaban, warfarin initiation was associated with a higher rate of major bleeding (HR 1.85; 95% CI 1.59-2.15), including major gastrointestinal bleeding (1.86; 1.53-2.25) and intracranial bleeding (2.15; 1.42-3.25). Rivaroxaban vs. apixaban was also associated with a higher rate of major bleeding (1.69; 1.33-2.15). All-cause mortality was similar for warfarin (1.08; 0.98-1.18) or rivaroxaban (0.94; 0.81-1.10) vs. apixaban. Furthermore, no statistically significant differences for ischemic stroke were observed for warfarin (1.14; 0.83-1.57) or rivaroxaban (0.71; 0.40-1.24) vs. apixaban, although confidence intervals were wide. Similar results were observed for warfarin vs. apixaban in the positive control cohort of patients with CKD stage 3, consistent with randomized trial findings.

LIMITATIONS: Few ischemic stroke events, potential residual confounding.

CONCLUSIONS: In patients with AF and advanced CKD, rivaroxaban and warfarin were associated with a higher rate of major bleeding compared with apixaban, suggesting a superior safety profile for apixaban in this high-risk population.

PMID:37839687 | DOI:10.1053/j.ajkd.2023.08.017

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Nevin Manimala Statistics

AUTHORS REPLY: High versus low target mean arterial pressure in septic shock in cirrhosis-A personalized TARGET-C approach may solve the conundrum!

J Hepatol. 2023 Oct 13:S0168-8278(23)05144-9. doi: 10.1016/j.jhep.2023.09.017. Online ahead of print.

NO ABSTRACT

PMID:37839676 | DOI:10.1016/j.jhep.2023.09.017

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Nevin Manimala Statistics

Molecular detection and associated risk factors of Anaplasma marginale, A. ovis and A. platys in sheep from Algeria with evidence of the absence of A. phagocytophilum

Acta Trop. 2023 Oct 13:107040. doi: 10.1016/j.actatropica.2023.107040. Online ahead of print.

ABSTRACT

Anaplasma species are obligate intracellular rickettsial pathogens that cause significant diseases in animals and humans. Despite their importance, limited information on Anaplasma infections in Algeria has been published thus far. This study aimed to assess the infection rate, characterize Anaplasma species, and identify associated risk factors in selected sheep farms across Oum El Bouaghi region in Algeria. In 2018, we collected 417 blood samples from sheep and performed molecular characterization of Anaplasma species infecting these animals. This characterization involved the use of 16S rRNA, msp2, rpoB, and msp5 genes, which were analyzed through nested PCR, qPCR, cPCR, DNA sequencing, and subsequent phylogenetic analysis. Our findings revealed infection rates of 12.7% for Anaplasma species detected, with Anaplasma ovis at 10.8%, Anaplasma marginale at 1.7%, and Anaplasma platys at 0.2%. Interestingly, all tested animals were found negative for Anaplasma phagocytophilum. Statistical analyses, including the Chi-square test and Fisher exact test, failed to establish any significant relationships (p>0.05) between A. ovis and A. platys infections and variables such as age, sex, sampling season, and tick infestation level. However, A. marginale infection exhibited a significant association with age (p<0.05), with a higher incidence observed in lambs (5.2%) compared to other age groups. Remarkably, this study represents the first molecular detection of A. platys and A. marginale in Algerian sheep. These findings suggest that Algerian sheep may serve as potential reservoirs for these pathogens. This research contributes valuable insights into the prevalence and characteristics of Anaplasma infections in Algerian sheep populations, emphasizing the need for further investigation and enhanced surveillance to better understand and manage these diseases.

PMID:37839669 | DOI:10.1016/j.actatropica.2023.107040

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Nevin Manimala Statistics

COG1410 regulates microglial states and protects retinal ganglion cells in retinal ischemia-reperfusion injury

Exp Eye Res. 2023 Oct 13:109678. doi: 10.1016/j.exer.2023.109678. Online ahead of print.

ABSTRACT

Progressive loss of retinal ganglion cells (RGCs) caused by retinal ischemia-reperfusion (IR) injury can lead to irreversible vision impairment, with neuroinflammatory responses playing an important role in this process. COG1410, a mimetic peptide of apolipoprotein E, has demonstrated protective potential in the central nervous system, but its effects on retinal IR injury remain unexplored. In this study, we established a mouse model of retinal IR injury to investigate the effects of COG1410 on retinal microglia and RGCs. We observed CD16/32-marked and CD206-marked microglia and RGCs using immunofluorescence staining, detected the expression of inflammatory factors by PCR, and evaluated retinal apoptosis with TUNEL staining. We further investigated the potential mechanism by detecting the expression of key proteins via western blot. The results reveal that COG1410 decreased the number of CD16/32-marked microglia and increased the number of CD206-marked microglia, alleviated the expression of IL-1β and TNF-α, and reduced the loss of RGCs by inhibiting the mitochondrial-related apoptotic pathway. COG1410 was found to increase the expression of ERK1/2 and Nr4a1 but decrease the expression of NF-κB. The expression of TREM2 showed an increasing trend after COG1410 administration, but it was not statistically significant. In conclusion, COG1410 regulates microglial states and protects RGCs in retinal IR injury, showing promising potential for the treatment of eye diseases.

PMID:37839665 | DOI:10.1016/j.exer.2023.109678

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Nevin Manimala Statistics

Should Mitral Valve Replacement Age Guidelines Be Lowered Due to Better Bioprosthetic Mitral Valve Durability?

J Thorac Cardiovasc Surg. 2023 Oct 13:S0022-5223(23)00968-6. doi: 10.1016/j.jtcvs.2023.10.012. Online ahead of print.

ABSTRACT

OBJECTIVE: Guideline recommendations for mechanical or bioprosthetic (BP) valve for MVR by age remains controversial. We sought to determine bovine pericardial valve durability by age, and risk of reintervention.

METHODS: This retrospective study between 2 large university-based cardiac surgery programs examined patients who underwent BP MVR from 2004 to 2020. Follow-up was obtained through June 2022. Durability outcomes involving structural valve deterioration (SVD) were compared by age decile.

RESULTS: Of 1544 available patients, mean age was 66±13 years and 652 (42%) were < 65 years old. Indications for MVR were: MR>2+ 53% [n=813]; mitral stenosis 44% [n=650]; endocarditis 18% [n=277] and reoperation in 39% [n=602]. Concomitant procedures were AVR 28% [n=426]; Tricuspid valve 36% [n=550]; CAB 19% [n=290]. Thirty-day mortality was 5.4%. In follow-up (clinical: median [IQR] 75 [25-129] months) reoperation for endocarditis, and new stroke were low (0.30 and 1.06 per 100 patient/years, respectively). The cumulative incidence of MV reintervention for SVD among all patients was 6.2% at 10 years 9.0% at 12 years with no statistical difference in SVD among patients between the ages of 40 and 70 years (p=0.1). Among 90 patients with MV reintervention, 30-day mortality after reintervention was 4.7% (n=2) for 43 MViV and 6.4% (n=3) among 47 reoperation patients.

CONCLUSIONS: Bovine pericardial MVR is a durable option for younger patients. The opportunity to avoid anticoagulation and the associated risks with mechanical MVR may be of benefit to patients. These insights may provide data needed to revise the current guidelines.

PMID:37839657 | DOI:10.1016/j.jtcvs.2023.10.012