Tag: pubmed

BMJ Open. 2023 Oct 12;13(10):e070444. doi: 10.1136/bmjopen-2022-070444.

ABSTRACT

OBJECTIVE: The present study investigated the province-level distribution and drivers of infant mortality rate (IMR) in mainland China.

DESIGN: Ecological analysis based on publicly available data for all 31 provinces in mainland China.

DATA SOURCES: Data on province-level IMRs in 2020 were obtained from the official websites of the healthcare commissions within each province and from the China Health Statistics Yearbook 2021. Data on potential IMR drivers were retrieved from the China Statistical Yearbook 2021.

DATA ANALYSIS: GeoDa V.1.12.1 and ArcMap V.10.2 software were used to examine province-level distribution of IMR. Global and local spatial autocorrelations were performed, and Getis-ord G* hotspots and coldspots were identified. Geodetector was used to analyse the individual and joint influence of drivers on IMR.

RESULTS: IMRs in 2020 varied from 1.91 to 7.60 per 1000 live births across provinces. The following statistically significant drivers with q values >0.5 were identified: health literacy of the population (0.6673), male illiteracy rate (0.6433), proportion of the population older than >65 years (0.6369), per capita government health expenditure (0.6216), forest coverage rate (0.5820), per capita disposable income (0.5785), per capita number of hospitals (0.5592), per capita gross regional product (0.5410) and sulfur dioxide concentration in the atmosphere (0.5158). The following three interactions among these drivers emerged as strongest influences on province-level IMR: proportion of population >65 years ∩ per capita gross regional product (q=0.9653), forest coverage rate ∩ per capita gross regional product (0.9610) and per capita government health expenditure ∩ sulfur dioxide (0.9295).

CONCLUSION: IMR in mainland China varies substantially across the country, being generally high-west and low-east. Several factors, on their own and interacting together, contribute to IMR. Policies and programmes to reduce IMR should be formulated according to local conditions and should focus on western provinces of the country.

PMID:37827731 | DOI:10.1136/bmjopen-2022-070444

BMJ Glob Health. 2023 Oct;8(10):e012633. doi: 10.1136/bmjgh-2023-012633.

ABSTRACT

INTRODUCTION: Increasing handwashing with soap (HWWS) among older children in emergency settings can have a large public health impact, however, evidence on what works is limited. One promising approach is the ‘Surprise Soap’ intervention in which a novel soap with an embedded toy is delivered to children in a short, participatory household session that includes a glitter game and HWWS practice. Here, we evaluate this intervention against a standard intervention in a complex emergency setting.

METHODS: A cluster-randomised controlled equivalence trial was conducted in Naivasha refugee settlement, Sudan. Blinding was not possible. 203 randomly selected households, with at least one child aged 5-12, were randomised to receive the Surprise Soap intervention (n=101) or a standard intervention comprising a short household session with health messaging and plain soap distribution (n=102). The primary outcome was the proportion of prespecified potential HWWS events observed for children aged 5-12, accompanied by HWWS, at baseline, 4, 12 and 16 weeks post intervention delivery.

RESULTS: 200 households were included in the analyses: 101 intervention and 99 control. No difference in intervention effectiveness was observed at any follow-up (4 weeks: adjusted rate ratio (RR) 1.2, 95% CI 0.8 to 1.7; 12 weeks: RR 0.8, 95% CI 0.5 to 1.1; 16 weeks: RR 1.1, 95% CI 0.8 to 1.5). However, we observed increased HWWS in both arms at 4 weeks (27 and 23 percentage point increase in the intervention and control arm, respectively) that was sustained at 16 weeks.

CONCLUSIONS: We find that the Surprise Soap intervention is no more effective at increasing older children’s HWWS than a standard, household-level, health-based intervention in this complex humanitarian emergency. There appears to be no marginal benefit in terms of HWWS that would justify the additional cost of implementing the Surprise Soap intervention. Further trials that include a passive control arm are needed to determine the independent effects of each intervention and guide future intervention design.

PMID:37827726 | DOI:10.1136/bmjgh-2023-012633

AJNR Am J Neuroradiol. 2023 Oct 12. doi: 10.3174/ajnr.A8024. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: DWI-detected ischemic lesions are potential complications of endovascular procedures that are performed to treat intracranial aneurysms. We completed a systematic review and meta-analysis to identify the occurrence of DWI-detected ischemic lesions after endovascular treatment for intracranial aneurysms.

MATERIALS AND METHODS: A systematic literature search of PubMed, the Web of Science, EMBASE, and Scopus between January 2000 and June 2022 of post-endovascular procedures for intracranial aneurysm studies was conducted using the Nested Knowledge AutoLit software. The main outcome was DWI-detected ischemic lesions within 5 days of the procedures. Information regarding associated risk factors such as the type of procedure, patient demographics, and aneurysm characteristics was also collected.

RESULTS: Twenty-nine studies with 2686 patients were included. The overall incidence of DWI ischemic lesions was 47.0% (95% CI, 39.6%-55.8%). The highest rate of lesions was seen with flow diversion at 62.4% (95% CI, 48.4%-80.5%), followed by complex procedures at 49.3% (95% CI, 29.5%-82.1%), stent-assisted coiling at 47.5% (95% CI, 34.6%-65.3%), simple coiling at 47.1% (95% CI, 35.7%-62.3%), and balloon-assisted coiling at 37.0% (95% CI, 28.3%-48.4%). The differences among different techniques were not statistically significant; however, there was significant heterogeneity and a significant risk of publication bias among included studies.

CONCLUSIONS: Many patients who undergo endovascular procedures for intracranial aneurysms present with new postprocedural DWI-detected ischemic lesions, regardless of the endovascular procedure used. Future studies and meta-analyses are needed to investigate early and long-term outcomes of such small infarcts.

PMID:37827721 | DOI:10.3174/ajnr.A8024

AJNR Am J Neuroradiol. 2023 Oct 12. doi: 10.3174/ajnr.A8003. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Several nonrandomized studies have demonstrated the effectiveness of balloon guide catheters in treating patients with anterior circulation large-vessel occlusion. However, their impact on the elderly populations has been underreported. We aimed to analyze the effect of balloon guide catheters in a cohort of elderly patients (80 years of age or older) with anterior circulation large-vessel occlusion.

MATERIALS AND METHODS: Consecutive patients from June 2019 to June 2022 were collected from the ROSSETTI Registry. Demographic and clinical data, angiographic endovascular technique, and clinical outcome were compared between balloon guide catheter and non-balloon guide catheter groups. We studied the association between balloon guide catheters and the rate of complete recanalization after a single first-pass effect modified TICI 2c-3, as well as their association with functional independence at 3 months.

RESULTS: A total of 808 patients were included during this period, 465 (57.5%) of whom were treated with balloon guide catheters. Patients treated with balloon guide catheters were older, had more neurologic severity at admission and lower baseline ASPECTS, and were less likely to receive IV fibrinolytics. No differences were observed in terms of the modified first-pass effect between groups (45.8 versus 39.9%, P = .096). In the multivariable regression analysis, balloon guide catheter use was not independently associated with a modified first-pass effect or the final modified TICI 2c-3, or with functional independence at 3 months.

CONCLUSIONS: In our study, balloon guide catheter use during endovascular treatment of anterior circulation large-vessel occlusion in elderly patients did not predict the first-pass effect, near-complete final recanalization, or functional independence at 3 months. Further studies, including randomized clinical trials, are needed to confirm these results.

PMID:37827717 | DOI:10.3174/ajnr.A8003

Int J Spine Surg. 2023 Oct 12:8547. doi: 10.14444/8547. Online ahead of print.

ABSTRACT

OBJECTIVE: To our knowledge, this is the first systematic review to evaluate the available literature on the effects of perioperative serum glucose (SG) on outcomes for patients undergoing spine surgery. This review will add insight into how the perioperative management of SG affects the outcomes of patients undergoing spine surgery.

METHODS: Three databases were used in this review including Embase, PubMed, and Cochrane Library. The searches were from 2012 to 2022 and included the terms “spine surgery” and “glucose level” to identify studies that demonstrated a correlation between glucose level and postoperative outcomes. Pediatric studies, those that did not specify spine surgical outcomes related to glucose levels, and non-English studies were excluded. The methodological items for nonrandomized studies score was used to assess risk of bias in the included studies.

RESULTS: This review included a total of 9 cohort studies, both prospective and retrospective, encompassing a total of 431,156 subjects. Seven of the 9 studies reported an increased overall complication rate among patients with diabetes or with higher SG levels, and 4 studies demonstrated an increased infection rate among this population. Two studies reported an association between decreased SG levels and improved neurological recovery when a deficit was present preoperatively, and 1 of the studies found that this association was statistically significant.

LIMITATIONS: Limitations of this review include lack of standardization regarding type of surgery, location of the spine, and level of evidence.

CONCLUSION: Most of the current literature suggests that elevated SG levels in patients undergoing spine surgery likely leads to higher complication rates and may lead to increased infection rates, and this review reinforced the current evidence. Additionally, perioperative SG levels may be associated with the extent of neurological recovery after surgery, but further investigation may be warranted.

CLINICAL RELEVANCE: This review adds to the current body of evidence regarding perioperative SG levels and its association with complications.

PMID:37827709 | DOI:10.14444/8547

J Pharmacol Exp Ther. 2023 Oct 12:JPET-PI-2023-001663. doi: 10.1124/jpet.123.001663. Online ahead of print.

ABSTRACT

The chemical warfare agent sulfur mustard and its structural analog nitrogen mustard (NM) cause severe vesicating skin injuries. The pathologic mechanisms for the skin injury following mustard exposure are poorly understood, therefore, no effective countermeasure is available. Previous reports demonstrated the protective activity of carvedilol, an FDA-approved β-blocker, against ultraviolet radiation-induced skin damage. Thus, the current study evaluated the effects of carvedilol on NM-induced skin injuries in vitro and in vivo. In the murine epidermal cell line JB6 Cl 41-5a, β-blockers with different receptor subtype selectivity were examined. Carvedilol and both of its enantiomers R- and S-carvedilol were the only tested ligands statistically reducing NM-induced cytotoxicity. Carvedilol also reduced NM-induced apoptosis and p53 expression. In SKH-1 mice, NM increased epidermal thickness, damaged skin architecture, and induced NF-kB related pro-inflammatory genes as assessed by RT² Profiler{trade mark, serif} PCR Arrays. To model chemical warfare scenario, 30 minutes after exposure to NM, 10 µM carvedilol was applied topically. Twenty-four hours after NM exposure, carvedilol attenuated NM-induced epidermal thickening, which in such a short time is due to an anti-inflammatory activity; Ki-67 expression, a marker of cellular proliferation, and multiple pro-inflammatory genes. Supporting the in vitro data, the non-β-blocking R-enantiomer of carvedilol had similar effects as racemic carvedilol, and there was no difference between carvedilol and R-carvedilol in the RT² Profiler{trade mark, serif} PCR Array data suggesting that the skin protective effects are independent of the β-adrenergic receptors. These data suggest that the β-blocker carvedilol and its enantiomers can be repurposed as countermeasures against mustard-induced skin injuries. Significance Statement The chemical warfare agent sulfur mustard and its structural analog nitrogen mustard cause severe vesicating skin injuries for which no effective countermeasure is available. This study evaluated the effects of an FDA-approved b-blocker carvedilol on nitrogen mustard-induced skin injuries, to repurpose this cardiovascular drug as a medical countermeasure.

PMID:37827703 | DOI:10.1124/jpet.123.001663

Anal Chim Acta. 2023 Oct 23;1279:341762. doi: 10.1016/j.aca.2023.341762. Epub 2023 Sep 5.

ABSTRACT

Data sets derived from practical experiments often pose challenges for (robust) statistical methods. In high-dimensional data sets, more variables than observations are recorded and often, there are also data present that do not follow the structure of the data majority. In order to handle such data with outlying observations, a variety of robust regression and classification methods have been developed for low-dimensional data. The high-dimensional case, however, is more challenging, and the variety of robust methods is much more limited. The choice of the method depends on the specific data structure, and numerical problems are more likely to occur. We give an overview of selected robust methods as well as implementations and demonstrate the application with two high-dimensional data sets from tribology. We show that robust statistical methods combined with appropriate pre-processing and sampling strategies yield increased prediction performance and insight into data differing from the majority.

PMID:37827663 | DOI:10.1016/j.aca.2023.341762

Anal Chim Acta. 2023 Oct 23;1279:341822. doi: 10.1016/j.aca.2023.341822. Epub 2023 Sep 15.

ABSTRACT

BACKGROUND: Accurate methods to assess DNA integrity are needed for many biomolecular methods. A multiplex digital PCR (dPCR) method designed for interspaced target sequences can be used to assess sequence integrity of large DNA strands. The ratio of single positive partitions versus double positive partitions is then used to calculate the sheared DNA strands. However, this simple calculation is only valid with low DNA concentration. We here describe a method based on probability calculations which enables DNA quality analysis in a large dynamic range of DNA concentrations.

RESULTS: Known DNA integrity percentages were mimicked using artificial double stranded DNA in low, intermediate and high DNA concentration scenarios, respectively 600, 12500 and 30000 copies of DNA per reaction. At low concentrations both methods were similar. However, at the intermediate concentration (12500 copies per reaction) the ratio based method started producing a larger error than the proposed probability calculation method with a mean relative error of 20.7 and 16.7 for the Bruner and the proposed method respectively. At the high concentration (30000 copies per reaction) only the proposed method provided accurate measurements with a mean relative error of 60.9 and 9.3 for the ratio based and the proposed method respectively. Furthermore, while both methods have a bias, it is constant for the proposed method, while it decreases with the integrity of the DNA for the ratio based method. The probability calculation equation was extended to 4 dimensions and a proof of concept experiment was performed, the data suggested that the 4 dimensional equation is valid.

SIGNIFICANCE AND NOVELTY: We here validate a method of estimating DNA integrity with dPCR using multiple probe combinations, allowing fast and flexible DNA integrity analysis. Additionally, we extend the method from 2 to 4 plex for more accurate DNA integrity measurements.

PMID:37827643 | DOI:10.1016/j.aca.2023.341822

Anal Chim Acta. 2023 Oct 23;1279:341781. doi: 10.1016/j.aca.2023.341781. Epub 2023 Sep 6.

ABSTRACT

A water-soluble negative sulfonic propyl ether β-CD polymer (SPE-β-CDP) to be used as chiral selector in capillary electrophoresis (CE) was polymerized. The sulfonic substitution degree of each β-CD in SPE-β-CDP was statistically homogenized. The only one negative peak in electrophoretogram with indirect ultraviolate method proved its uniformity of electrophoretic behavior. There were 7.12 sulfonic substitution in β-CD unit and 164 μmole β-CD units in each gram of SPE-β-CDP, which corresponded a molecular weight of 7000 or more. Compared with monomer, SPE-β-CDP was lower effect on electrical current of CE, indicating a high concentration of SPE-β-CDP could be added. Its separation ability was verified by 12 chiral drugs. SPE-β-CDP also showed advantages of good water solubility, easy preparation and recovery to reduce the overall cost. However, five of 12 chiral drugs were hardly to be fully separated which was normal for any kind of chiral selector. A newly adjustable gravity mediated capillary electrophoresis (AGM-CE) technology was proposed and combined with SPE-β-CDP to enhance the chiral separation efficiencies of propranolol, salbutamol, omeprazole, ofloxacin and phenoxybenzamine which were markedly improved to 3.02, 1.17, 7.63, 4.14, and 2.81, respectively. Furthermore, its gradient mode (AGMg-CE) was also used to improve resolution through utilizing the zero mobility point, at which the effective apparent mobility of one racemate was zero. Resolutions of five chiral drugs were significantly improved, especially resolution of carvedilol changed from 0.43 to 1.0. These indicated SPE-β-CDP as chiral selector, AGM-CE and AGMg-CE as new CE technologies had a great potential in chiral separation.

PMID:37827633 | DOI:10.1016/j.aca.2023.341781

Anal Chim Acta. 2023 Oct 23;1279:341809. doi: 10.1016/j.aca.2023.341809. Epub 2023 Sep 8.

ABSTRACT

Intracellular metabolic profiling reveals real-time metabolic information useful for the study of underlying mechanisms of cells in particular conditions such as drug resistance. However, mass spectrometry (MS), one of the leading metabolomics technologies, usually requires a large number of cells and complex pretreatments. Surface enhanced Raman scattering (SERS) has an ultrahigh detection sensitivity and specificity, favorable for metabolomics analysis. However, some targeted SERS methods focus on very limited metabolite without global bioprofiling, and some label-free approaches try to fingerprint the metabolic response based on whole SERS spectral classification, but comprehensive interpretation of biological mechanisms was lacking. (95) RESULTS: We proposed a label-free SERS technique for intracellular metabolic profiling in complex cellular lysates within 3 min. We first compared three kinds of cellular lysis methods and sonication lysis shows the highest extraction efficiency of metabolites. To obtain comprehensive metabolic information, we collected a spectral set for each sample and further qualified them by the Pearson correlation coefficient (PCC) to calculate how many spectra should be acquired at least to gain the adequate information from a statistical and global view. In addition, according to our measurements with 10 pure metabolites, we can understand the spectra acquired from complex cellular lysates of different cell lines more precisely. Finally, we further disclosed the variations of 22 SERS bands in enzalutamide-resistant prostate cancer cells and some are associated with the androgen receptor signaling activity and the methionine salvage pathway in the drug resistance process, which shows the same metabolic trends as MS. (149) SIGNIFICANCE: Our technique has the capability to capture the intracellular metabolic fingerprinting with the optimized lysis approach and spectral set collection, showing high potential in rapid, sensitive and global metabolic profiling in complex biosamples and clinical liquid biopsy. This gives a new perspective to the study of SERS in insightful understanding of relevant biological mechanisms. (54).

PMID:37827617 | DOI:10.1016/j.aca.2023.341809