Tag: pubmed

Clin Neurol Neurosurg. 2023 Jun 23;232:107846. doi: 10.1016/j.clineuro.2023.107846. Online ahead of print.

ABSTRACT

BACKGROUND: Several studies demonstrated the association between tobacco smoking and higher risk and increased progression of multiple sclerosis (MS). Data about the effect of smoking during the recovery from MS attacks is limited. Furthermore, different types of tobacco exposures such as water pipe and passive smoking are not well assessed separately. So this study evaluated the effect of different types of smokes, cigarette and water pipe as well as passive smoking on the function recovery of relapsing-remitting MS (RRMS) attacks METHODS: This cohort study evaluated the adult patients with RRMS and Expanded Disability Status Scale (EDSS) < 5 in the attack phase. Patients were divided into two groups: smokers and non-smokers. The smokers included those who use cigarette, water pipe as well as passive smokers as subgroups for more analyses later. EDSS was monitored after relapse and two months after relapse. Change of EDSS considered as the criteria for functional recovery. The correlation between the amount of consumption and disability level was assessed among smokers by Pearson’s correlation test. While, the difference of EDSS between smoker and non-smoker were assessed by Independent samples T-test.

RESULTS: 142 patients were evaluated. 79 (55.6%) were smokers (43% male) while 63 (44.4%) were non-smokers (36.5% male). There was a statistically significant difference in change of EDSS between smoker and non-smoker groups, which change of EDSS was higher in non-smoker (-2.62 ± 0.90 non-smoker vs. -1.75 ± 0.76 smoker, P < 0.001). Also, only there was a significantly lesser decline in EDSS after two months in the cigarette smokers in subgroups analyses (P < 0.001). A correlation analysis revealed a significant positive correlation between the number per day of cigarette smoking and EDSS after relapse (r = 0.3, P = 0.03) and a significant positive correlation between minutes per month of smoking of water pipe and EDSS two months after relapse (r = ‎0.6‎‎, P > 0.001).

CONCLUSION: Tobacco smoking especially cigarette smoking is associated with a negative effect on recovery from the attack in patients with RRMS.

PMID:37467576 | DOI:10.1016/j.clineuro.2023.107846

Leuk Res. 2023 Jul 12;132:107354. doi: 10.1016/j.leukres.2023.107354. Online ahead of print.

ABSTRACT

The treatment patterns for patients with newly diagnosed acute myeloid leukemia (AML) were compared between 2013 and 16 and 2021-22 in a real-world setting. A significantly higher proportion of patients age 70 and over received non-intensive therapy (NIT) in 2021-22 as compared with 2013-16 (65 % vs 44 %, p = 0.014), with a corresponding reduction in the proportion receiving either intensive therapy or no antileukemic treatment. Treatment patterns among patients < age 70 were unchanged. The complete response rate in the NIT group was 69 % in 2021-22 vs. 24 % in 2013-16 (p < 0.001); the overall survival (OS) of NIT patients was 11.5 months in 2021-22 vs. 7.8 months in 2013-16. Older patients from rural areas were more likely to decline therapy than those from urban regions. The increase in the proportion of patients opting for NIT may be related to the availability of more effective treatment options. Although outcomes are improving, the OS with NIT remains suboptimal.

PMID:37467567 | DOI:10.1016/j.leukres.2023.107354

Ecotoxicol Environ Saf. 2023 Jul 17;263:115257. doi: 10.1016/j.ecoenv.2023.115257. Online ahead of print.

NO ABSTRACT

PMID:37467562 | DOI:10.1016/j.ecoenv.2023.115257

Comput Biol Med. 2023 Jul 10;164:107237. doi: 10.1016/j.compbiomed.2023.107237. Online ahead of print.

ABSTRACT

Medical datasets are primarily made up of numerous pointless and redundant elements in a collection of patient records. None of these characteristics are necessary for a medical decision-making process. Conversely, a large amount of data leads to increased dimensionality and decreased classifier performance in terms of machine learning. Numerous approaches have recently been put out to address this issue, and the results indicate that feature selection can be a successful remedy. To meet the various needs of input patterns, medical diagnostic tasks typically involve learning a suitable categorization model. The k-Nearest Neighbors algorithm (kNN) classifier’s classification performance is typically decreased by the input variables’ abundance of irrelevant features. To simplify the kNN classifier, essential attributes of the input variables have been searched using the feature selection approach. This paper presents the Coati Optimization Algorithm (DCOA) in a dynamic form as a feature selection technique where each iteration of the optimization process involves the introduction of a different feature. We enhance the exploration and exploitation capability of DCOA by employing dynamic opposing candidate solutions. The most impressive feature of DCOA is that it does not require any preparatory parameter fine-tuning to the most popular metaheuristic algorithms. The CEC’22 test suite and nine medical datasets with various dimension sizes were used to evaluate the performance of the original COA and the proposed dynamic version. The statistical results were validated using the Bonferroni-Dunn test and Kendall’s W test and showed the superiority of DCOA over seven well-known metaheuristic algorithms with an overall accuracy of 89.7%, a feature selection of 24%, a sensitivity of 93.35% a specificity of 96.81%, and a precision of 93.90%.

PMID:37467535 | DOI:10.1016/j.compbiomed.2023.107237

Environ Int. 2023 Jul 14;178:108098. doi: 10.1016/j.envint.2023.108098. Online ahead of print.

ABSTRACT

Groundwater is an important human resource. Daejeon in South Korea faces severe water quality issues, including radon, uranium, and fluoride pollution, all of which pose health risks to humans. With climate change, threats to potable water, such as heavy rain and typhoons, have become common. Therefore, examining the seasonal effects on groundwater quality and resultant health risks is important for understanding the mechanisms of different hydroclimatological conditions to enable the implementation of sustainable management plans in radon-contaminated groundwater areas. However, this issue has not yet been studied. To bridge this gap, in this study, major ions and microbial community structures were employed and groundwater quality index (GWQI) were calculated with hazard index based on limits set by the World Health Organization (WHO) to investigate the hydrochemical characterization and to assess pollution levels. The results showed that the rainy season had distinct hydrochemical characteristics with high correlations between radon and fluoride, and most groundwater samples collected after the typhoon had characteristics similar to those collected during the dry season, owing to the flow path. Furthermore, the microbial diversity and hazard quotient (HQ) values of fluoride revealed that pollution worsened during the dry season. All of the calculated effective dose values of radon exceeded the threshold limit set by the WHO, despite the low GWQI. Infants and children were particularly susceptible to radon-contaminated groundwater. The statistical results of self-organizing map (SOM) suggested that radon analysis was sufficient for public health intervention in the rainy season; however, in the dry season, combined analyses of radon, fluoride, and microbial diversity played important roles in health risk assessment. Our study presents a comprehensive understanding of radon-contaminated groundwater characteristics under seasonal effects and can serve as a reference for other similar zones to provide significant insights into the effective management of radon contamination.

PMID:37467531 | DOI:10.1016/j.envint.2023.108098

Nutrition. 2023 Jun 14;114:112131. doi: 10.1016/j.nut.2023.112131. Online ahead of print.

ABSTRACT

OBJECTIVES: The Body Composition Monitor (BCM) (Fresenius Medical Care) measures body impedances in alternating currents to subsequently calculate fat and lean tissue mass, fluid compartments, and overhydration (OH). The aim of this study was to investigate differences between two versions of the BCM (an older version, 3.2.5, and a newer version, 3.3.3).

METHODS: Between September 2021 and December 2021, 28 hemodialysis patients were included to undergo BCM measurements before each of 14 consecutive dialysis sessions with versions 3.2.5 and 3.3.3 devices. Measurements were performed according to instructions provided by the manufacturer. Differences between BCM devices were tested for statistical significance using paired Wilcoxon tests, neglecting clustering.

RESULTS: A total of 288 measurement pairs of 27 patients were left after exclusion of 43 flawed data points. The mean difference in OH between both BCM devices was 0.548 L (higher for version 3.2.5). Analysis of impedance data revealed differences in the high-frequency spectrum, quantifiable by the intracellular resistance, R_i (median R_{i version 3.2.5} = 1750.3 Ω; R_{i version 3.3.3} = 1612.45 Ω; P < 0.001), and the time delay, T_d (median T_{d version 3.2.5} = 1.85 ns; T_{d version 3.3.3} = 8.88 nanoseconds; P < 0.001).

CONCLUSIONS: This study finds that results between the two versions of the BCM differed in a clinically meaningful fashion and that the newer version 3.3.3 device had a bias toward less OH. Circulating BCM devices should be checked for versions and only devices of the same version should be used for each patient to ensure better within-patient consistency.

PMID:37467529 | DOI:10.1016/j.nut.2023.112131

J Clin Neurosci. 2023 Jul 17;115:29-32. doi: 10.1016/j.jocn.2023.07.012. Online ahead of print.

ABSTRACT

BACKGROUND: Microcatheter shaping plays a vital role in coil embolization of cerebral aneurysms, while the complicated method and insufficient training opportunities make it difficult for junior neurovascular clinicians to master this technique. In this program, we constructed a novel training method and assessment system for microcatheter shaping in coil embolization of cerebral aneurysms with 3D technique, and evaluated its efficacy for microcatheter shaping training in junior neurovascular clinicians.

METHODS: Patient-specific models for cerebral aneurysms in different locations and with different morphologies were selected by experienced senior neurovascular clinicians. The solid polylactic acid model and the soft hollow crystal silicone model of intracranial aneurysms were then made separately for shaping reference and assessment in the training course. Twelve residents without prior experience of microcatheter shaping and 25 neurovascular clinicians who have in vivo experience of microcatheter shaping on 3-5 occasions were selected for this training program and randomly divided into the traditional training group and the experimental training group. Four senior neurovascular clinicians assisted and guided the trainees in two groups and evaluated the time and accuracy of microcatheter shaping.

RESULTS: Eighteen trainees were assigned to the traditional training group, among which 4 had prior experience in microcatheter shaping. The other 19 were assigned to the experimental training group, including 8 with prior experience. No statistical difference in the distribution of experienced students between the two groups was noted(P = 0.295). After the training session, the shaping time was found shorter in the experimental training group than that in the traditional training group (40.3.5 ± 16.2 s vs. 54.2 ± 16.4 s, P = 0.014), while the shaping score was found higher in the experimental training group than that in the traditional training group (4.4 ± 0.5 vs. 2.6 ± 1.2, P < 0.001). Specifically, for the trainees without prior experience, the experimental training group also showed less time consumption and higher score (Time: 52.7 ± 7.7 vs. 61.5 ± 9.5, P = 0.02; Score 4.1 ± 0.5 vs. 2.3 ± 1.1, P < 0.01). Meanwhile, for the trainees with prior experience, the advantage was noted in shaping score (4.7 ± 0.3 vs. 3.9 ± 0.6, P < 0.01) but not in time consumption (23.3 ± 4.4 vs. 28.5 ± 3.9, P = 0.07).

CONCLUSION: This training program is quite effective at teaching junior neurovascular physicians the essential surgical abilities required for coiling cerebral aneurysms.

PMID:37467525 | DOI:10.1016/j.jocn.2023.07.012

Soc Sci Med. 2023 Jul 1;331:116063. doi: 10.1016/j.socscimed.2023.116063. Online ahead of print.

ABSTRACT

Birthweight is a widely-used biomarker of infant health, with inequities patterned intersectionally by maternal age, race/ethnicity, nativity/immigration status, and socioeconomic status in the United States. However, studies of birthweight inequities almost exclusively focus on singleton births, neglecting high-risk twin births. We address this gap using a large sample (N = 753,180) of birth records, obtained from the 2012-2018 New York City (NYC) Department of Health and Mental Hygiene, Bureau of Vital Statistics, representing 99% of all births registered in NYC, and a novel random coefficients intersectional MAIHDA (Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy) model. Our results show evidence of intersectional inequities in birthweight outcomes for both twin and singleton births by maternal age, race/ethnicity, education, and nativity status. Twins have considerably lower predicted birthweights than singletons overall (-930 g on average), and this is especially true for babies born to mothers who are younger (11-19 years), older (40+), racial/ethnic minoritized, foreign-born, and have lower education. However, the magnitude of this birthweight ‘gap’ between twins and singletons varies considerably across social identity strata, ranging between 830.8 g (observed among 40+ year old Black foreign-born mothers with high school degrees) and 1013.7 g (observed among 30-39 year old Hispanic/Latina foreign-born mothers with less than high school degrees). This study underscored the needs of a high-risk population and the need for aggressive social policies to address health inequities and dismantle intersectional systems of marginalization, oppression, and socioeconomic inequality. In addition to our substantive contributions, we add to the growing methods literature on intersectional quantitative analysis by demonstrating how to apply intersectional MAIHDA with random coefficients and random slopes. We conclude with a discussion of the significant potential for this methodological extension in future research on inequities.

PMID:37467517 | DOI:10.1016/j.socscimed.2023.116063

J Pharm Pharmacol. 2023 Jul 19:rgad067. doi: 10.1093/jpp/rgad067. Online ahead of print.

ABSTRACT

OBJECTIVES: To illustrate the metabolic regulatory mechanisms of Jiangzhi decoction (JZD) against non-alcoholic fatty liver disease (NAFLD).

METHODS: High-fat diet (HFD)-induced NAFLD rats were treated with JZD. The pathological morphology, lipid indexes and liver function were detected. Metabolic profiles were examined by liquid chromatography-mass spectrometry (LC-MS). Multivariate and univariate statistical analysis were used to search the differential metabolites. Pathway enrichment analysis was carried out using Kyoto Encyclopedia of Genes and Genomes database. Compound-gene networks were built by Cytoscape software.

RESULTS: JZD significantly alleviated the pathological conditions and improved lipid index levels. Multivariate analysis showed a good separation among different groups. Three hundred and twenty-seven metabolites in HFD versus control and 301 metabolites in JZD versus HFD were identified to be significantly different. Pathway enrichment analysis showed that lipid metabolism pathways were prominent altered pathways. Importantly, the relationships were more distant between JZD and HFD groups in all five lipid metabolism pathways, including arachidonic acid metabolism, linoleic acid metabolism, biosynthesis of unsaturated fatty acids, glycerophospholipid metabolism and sphingolipid metabolism, while those were obviously closer between JZD and control groups. Simultaneously, JZD treatment restored the levels of disturbed differential metabolites in HFD group.

CONCLUSION: JZD had an effect on alleviating NAFLD via regulating relevant lipid metabolism.

PMID:37467485 | DOI:10.1093/jpp/rgad067

J Low Genit Tract Dis. 2023 Jul 19. doi: 10.1097/LGT.0000000000000759. Online ahead of print.

ABSTRACT

OBJECTIVES: This study aimed to determine the screening history and associated outcomes of women diagnosed with cervical cancer after age 65.

METHODS: All patients from 2012 to 2021 diagnosed with squamous, adenocarcinoma, neuroendocrine, or adenosquamous cervical cancer after age 65 in a single managed care organization (MCO) were included in this retrospective cohort study. Demographic, medical, screening, pathologic, follow-up, and treatment data were extracted. Statistical analysis was done using chi-square test and logistic regression. Cancer-specific survival was estimated using the Kaplan-Meier method.

RESULTS: Of 2,175 patients screened, 209 met inclusion criteria. Only 26.3% of patients had appropriate cervical cancer screening and 41% of patients died of their disease. Managed care organization membership duration of more than 5 years positively correlated with proper cervical cancer screening (p < .001); however, 64% of the long-term members still did not meet criteria to end screening at age 65, with 42.6% of these patients having more than 25 physician visit opportunities to address screening. Increased physician visits correlated with earlier stage at diagnosis of cervical cancer (p = .012). Median cancer-specific survival was significantly better in properly screened patients at 68 vs 30 months, respectively (p = .03).

CONCLUSIONS: Most patients diagnosed with cervical cancer after age 65 did not have adequate previous screening, including those who were MCO members for more than 5 years. There were many missed opportunities for screening, despite multiple provider touchpoints. Our data suggest that adequate screening confers a survival benefit secondary to earlier stage at diagnosis. Further study in this age group is needed to redefine the criteria to end cervix cancer screening.

PMID:37467471 | DOI:10.1097/LGT.0000000000000759