Tag: pubmed

PLoS One. 2023 Jul 11;18(7):e0287409. doi: 10.1371/journal.pone.0287409. eCollection 2023.

ABSTRACT

A blood-based integrated classifier (IC) has been clinically validated to improve accuracy in assessing probability of cancer risk (pCA) for pulmonary nodules (PN). This study evaluated the clinical utility of this biomarker for its ability to reduce invasive procedures in patients with pre-test pCA ≤ 50%. This was a propensity score matching (PSM) cohort study comparing patients in the ORACLE prospective, multicenter, observational registry to control patients treated with usual care. This study enrolled patients meeting the intended use criteria for IC testing: pCA ≤ 50%, age ≥40 years, nodule diameter 8-30 mm, and no history of lung cancer and/or active cancer (except for non-melanomatous skin cancer) within 5 years. The primary aim of this study was to evaluate invasive procedure use on benign PNs of registry patients as compared to control patients. A total of 280 IC tested, and 278 control patients met eligibility and analysis criteria and 197 were in each group after PSM (IC and control groups). Patients in the IC group were 74% less likely to undergo an invasive procedure as compared to the control group (absolute difference 14%, p <0.001) indicating that for every 7 patients tested, one unnecessary invasive procedure was avoided. Invasive procedure reduction corresponded to a reduction in risk classification, with 71 patients (36%) in the IC group classified as low risk (pCA < 5%). The proportion of IC group patients with malignant PNs sent to surveillance were not statistically different than the control group, 7.5% vs 3.5% for the IC vs. control groups, respectively (absolute difference 3.91%, p 0.075). The IC for patients with a newly discovered PN has demonstrated valuable clinical utility in a real-world setting. Use of this biomarker can change physicians’ practice and reduce invasive procedures in patients with benign pulmonary nodules. Trial registration: Clinical trial registration: ClinicalTrials.gov NCT03766958.

PMID:37432960 | DOI:10.1371/journal.pone.0287409

PLoS One. 2023 Jul 11;18(7):e0288265. doi: 10.1371/journal.pone.0288265. eCollection 2023.

ABSTRACT

This study examines whether income distribution in Thailand has a property of scale invariance or self-similarity across years. By using the data on income shares by quintile and by decile of Thailand from 1988 to 2021, the results from 306-pairwise Kolmogorov-Smirnov tests indicate that income distribution in Thailand is statistically scale-invariant or self-similar across years with p-values ranging between 0.988 and 1.000. Based on these empirical findings, this study would like to propose that, in order to change income distribution in Thailand whose pattern had been persisted for over three decades, the change itself cannot be gradual but has to be like a phase transition of substance in physics.

PMID:37432918 | DOI:10.1371/journal.pone.0288265

PLoS One. 2023 Jul 11;18(7):e0287440. doi: 10.1371/journal.pone.0287440. eCollection 2023.

ABSTRACT

BACKGROUND: Women who use hormonal contraception face delayed return of fertility upon discontinuation. There was limited evidence of fertility return after hormonal contraceptive discontinuation in the study area. Hence this study assessed fertility return after hormonal contraceptive discontinuation and associated factors among pregnant women attending Family Guidance Association Ethiopia (FGAE) Dessie model clinic, Northeast Ethiopia, 2019.

METHODS: A cross-sectional study was conducted on 423 samples selected by using systematic random sampling. Data were collected by face-to-face interview using a pretested and structured questionnaire and reviewing client records. Data were entered using Epi Data version 3.1 and analyzed using SPSS version 23. Both bi-variable and multivariable binary logistic regressions were used to identify predictors of delayed fertility return. Adjusted odds ratio (AOR) along with a 95% Confidence Interval (CI) was used to measure the strength and the direction of the association and statistical significance was declared at a P-value less than 0.05.

RESULT: The proportion of fertility return among currently pregnant women after discontinuation of any hormonal contraceptive methods was 88.6% (95% CI; (85.6%-92%)). The proportion of fertility return among Depo-Provera, implant, Intrauterine Contraceptive Device (IUCD), and Oral Contraceptive Pill (OCP) users was 75%, 99.1%, 100%, and 97.8% respectively. Age, (AOR = 5.37, (95% CI; (1.48, 13.6)) and using Depo-Provera (AOR = 4.82, 95% CI; (1.89, 14.2)) had a significant association with delayed fertility return.

CONCLUSIONS: The proportion of fertility return among women after discontinuation of any hormonal contraceptive methods was high. Age and using Depo-Provera had a positive association with delayed fertility return. This study recommends a contraceptive counseling approach that addresses concerns about delay in the return of fertility after hormonal contraceptive discontinuation to avoid confusion among family planning users.

PMID:37432916 | DOI:10.1371/journal.pone.0287440

PLoS One. 2023 Jul 11;18(7):e0288018. doi: 10.1371/journal.pone.0288018. eCollection 2023.

ABSTRACT

Men who have sex with men (MSM) experience a high degree of discrimination and marginalization in Senegal. Homophobia is pervasive in Senegalese society at the cultural, religious, and political levels. Its effects are reflected in the disproportionately high levels of depression, anxiety, and substance abuse among men who have sex with men when compared to the general population. Given the widespread stigma and the lack of structural support, healthcare providers play a critical role in reconciling the physical and psychological needs of men who have sex with men. This led to the design of a training program that aimed to improve the capacity of healthcare providers to deliver MSM-competent psychosocial care. The training was delivered virtually to 37 Senegal-based nurses and physicians. The program was quantitatively and qualitatively evaluated using pre- and post-testing. The findings demonstrate a general post-training increase in knowledge acquisition (9. 23%, p-value = 0.0021) and a 6.39% reduction in homophobia, which was statistically significant (p = 0.0376); with male providers outperforming female providers, and physicians outperforming nurses. This demonstrates the effectiveness and applicability of the program to support the psychosocial needs of men who have sex with men, and its capacity for future and broader implementation among healthcare providers.

PMID:37432914 | DOI:10.1371/journal.pone.0288018

J Hypertens. 2023 Jul 6. doi: 10.1097/HJH.0000000000003497. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare adherence to antihypertensive treatment between patients prescribed a three-drug single-pill combination (SPC) of perindopril/amlodipine/indapamide (P/A/I) vs. the combination of an angiotensin-converting enzyme inhibitor (ACEI), a calcium-channel blocker (CCB), and a diuretic (D) as a two-drug SPC plus a third drug given separately.

METHODS: Using the healthcare utilization database of the Lombardy Region (Italy), the 28 210 patients, aged at least 40 years, who were prescribed P/A/I SPC during 2015-2018 were identified and the date of the first prescription was defined as the index date. For each patient prescribed the SPC, a comparator who started ACEI/CCB/D treatment as a two-pill combination was considered. Adherence to the triple combination was assessed over the year after the index date as the proportion of the follow-up days covered by prescription (PDC). Patients who had a PDC >75% were defined as highly adherent to drug therapy. Log-binomial regression models were fitted to estimate the risk ratio of treatment adherence in relation to the drug treatment strategy.

RESULTS: About 59 and 25% of SPC and two-pill combination users showed high adherence, respectively. Compared with patients under a three-drug two-pill combination, those who were treated with the three-drug SPC had a higher propensity to be highly adherent to the triple combination (2.38, 95% confidence interval: 2.32-2.44). This was the case regardless of the sex, age, comorbidities, and number of co-treatments.

CONCLUSIONS: In a real-life setting, patients under three-drug SPC exhibited more frequently a high adherence to antihypertensive treatment than those prescribed a three-drug two-pill combination.

PMID:37432906 | DOI:10.1097/HJH.0000000000003497

J Hypertens. 2023 Jul 6. doi: 10.1097/HJH.0000000000003486. Online ahead of print.

ABSTRACT

INTRODUCTION: Hypertensive disorders of pregnancy are associated with adverse feto-maternal outcomes. Existing evidence is mostly limited to observational studies, which are liable to confounding and bias. This study investigated the causal relevance of component hypertensive indices on multiple adverse pregnancy outcomes using Mendelian randomization.

METHODS: Uncorrelated (r2 < 0.001) genome-wide significant (P < 5 × 10-8) single-nucleotide polymorphisms associated with SBP, DBP and pulse pressure (PP) were selected as instrumental variables. Genetic association estimates for outcomes of preeclampsia or eclampsia, preterm birth, placental abruption and hemorrhage in early pregnancy were extracted from summary statistics of genome-wide association studies in the FinnGen cohort. Two-sample, inverse-variance weighted Mendelian randomization formed the primary analysis method. Odds ratios (OR) are presented per-10 mmHg higher genetically predicted hypertensive index.

RESULTS: Higher genetically predicted SBP were associated with higher odds of preeclampsia or eclampsia [OR 1.81, 95% confidence interval (CI) 1.68-1.96, P = 5.45 × 10-49], preterm birth (OR 1.09, 95% CI 1.03-1.16, P = 0.005) and placental abruption (OR 1.33, 95% CI 1.05-1.68, P = 0.016). Higher genetically-predicted DBP was associated with preeclampsia or eclampsia (OR 2.54, 95% CI 2.21-2.92, P = 5.35 × 10-40). Higher genetically predicted PP was associated with preeclampsia or eclampsia (OR 1.68, 95% CI 1.47-1.92, P = 1.9 × 10-14) and preterm birth (OR 1.18, 95% CI 1.06-1.30, P = 0.002).

CONCLUSION: This study provides genetic evidence to support causal associations of SBP, DBP and PP on multiple adverse outcomes of pregnancy. SBP and PP were associated with the broadest range of adverse outcomes, suggesting that optimized management of blood pressure, particularly SBP, is a key priority to improve feto-maternal health.

PMID:37432894 | DOI:10.1097/HJH.0000000000003486

J Hypertens. 2023 Jul 6. doi: 10.1097/HJH.0000000000003504. Online ahead of print.

ABSTRACT

OBJECTIVE: Saline infusion test (SIT) requires 2 l of isotonic saline for intravenous infusion over 4 h to suppress plasma aldosterone concentration (PAC). To shorten the procedure time and minimize the volume load, we study the performance of SIT at 1, 2 and 4 h for diagnosing primary aldosteronism.

METHODS: This is a cross-sectional study. PAC was measured before and 1, 2 and 4 h after saline infusion at a rate of 500 ml/h in patients suspected to have primary aldosteronism. Primary aldosteronism was diagnosed based on 4 h PAC, adrenal imaging and/or adrenal venous sampling (AVS).

RESULTS: Of the 93 patients, 32 had primary aldosteronism. The area under the receiver operating characteristic (ROC) curve of the 1, 2 and 4 h PAC were not statistically different. All of the nonprimary aldosteronism group had a 1 h PAC lower than 15 ng/dl and all of the primary aldosteronism group had a 1 h PAC higher than 5 ng/dl. Nearly 30% of the nonprimary aldosteronism and primary aldosteronism groups had a 1 h PAC between 5 and 15 ng/dl (equivocal range) and could be discriminated by using percentage suppression of 1 h PAC from baseline. Using 1 h PAC of more than 15 ng/dl together with percentage suppression of 1 h PAC from baseline of less than 60 when 1 h PAC was 5-15 ng/dl, primary aldosteronism could be detected with a sensitivity of 93.7% and specificity of 96.7%.

CONCLUSION: The 1 h SIT has a similar diagnostic performance to the standard SIT. Using 1 h PAC together with percentage suppression from baseline when 1 h PAC is equivocal, primary aldosteronism can be diagnosed with good accuracy.

PMID:37432888 | DOI:10.1097/HJH.0000000000003504

Neural Comput. 2023 Jun 20:1-41. doi: 10.1162/neco_a_01595. Online ahead of print.

ABSTRACT

A stimulus can be encoded in a population of spiking neurons through any change in the statistics of the joint spike pattern, yet we commonly summarize single-trial population activity by the summed spike rate across cells: the population peristimulus time histogram (pPSTH). For neurons with a low baseline spike rate that encode a stimulus with a rate increase, this simplified representation works well, but for populations with high baseline rates and heterogeneous response patterns, the pPSTH can obscure the response. We introduce a different representation of the population spike pattern, which we call an “information train,” that is well suited to conditions of sparse responses, especially those that involve decreases rather than increases in firing. We use this tool to study populations with varying levels of burstiness in their spiking statistics to determine how burstiness affects the representation of spike decreases (firing “gaps”). Our simulated populations of spiking neurons varied in size, baseline rate, burst statistics, and correlation. Using the information train decoder, we find that there is an optimal level of burstiness for gap detection that is robust to several other parameters of the population. We consider this theoretical result in the context of experimental data from different types of retinal ganglion cells and determine that the baseline spike statistics of a recently identified type support nearly optimal detection of both the onset and strength of a contrast step.

PMID:37432862 | DOI:10.1162/neco_a_01595

Invest Ophthalmol Vis Sci. 2023 Jul 3;64(10):10. doi: 10.1167/iovs.64.10.10.

ABSTRACT

PURPOSE: The purpose of this study was to identify diabetes-related risk factors for exudative age-related macular degeneration (AMD).

METHODS: This was a nationwide population-based cohort study using authorized clinical data provided by the Korean National Health Insurance Service. A total of 1,768,018 participants with diabetes over 50 years of age participated in the Korean National Health Screening Program between 2009 and 2012. Data on covariates, including age, sex, income level, systemic comorbidities, behavioral factors, and diabetes-related parameters, including duration of diabetes, use of insulin for diabetes control, number of oral hypoglycemic agents used, and accompanying vision-threatening diabetic retinopathy, were collected from health screening results and claims data. Patients were followed up until December 2018. Incident cases of exudative AMD were identified using registered diagnostic codes from the claims data. The prospective association of diabetes-related parameters with incident exudative AMD was investigated using the multivariable-adjusted Cox proportional hazard model.

RESULTS: During an average follow-up period of 5.93 years, 7331 patients were newly diagnosed with exudative AMD. Compared to those who had diabetes for less than 5 years, individuals with diabetes for 5 years or more had a greater risk of future exudative AMD development, with a hazard ratio (95% confidence interval) of 1.13 (1.07-1.18) in the fully adjusted model. Use of insulin for diabetes control and the presence of vision-threatening diabetic retinopathy were also associated with an increased risk of exudative AMD with a hazard ratio (95% confidence interval) of 1.16 (1.07-1.25) and 1.40 (1.23-1.61), respectively.

CONCLUSIONS: A longer duration of diabetes, administration of insulin for diabetes control, and comorbid vision-threatening diabetic retinopathy were associated with an increased risk of developing exudative AMD.

PMID:37432847 | DOI:10.1167/iovs.64.10.10

J Chem Inf Model. 2023 Jul 11. doi: 10.1021/acs.jcim.3c00504. Online ahead of print.

ABSTRACT

The skew and shape of the molecular weight distribution (MWD) of polymers have a significant impact on polymer physical properties. Standard summary metrics statistically derived from the MWD only provide an incomplete picture of the polymer MWD. Machine learning (ML) methods coupled with high-throughput experimentation (HTE) could potentially allow for the prediction of the entire polymer MWD without information loss. In our work, we demonstrate a computer-controlled HTE platform that is able to run up to 8 unique variable conditions in parallel for the free radical polymerization of styrene. The segmented-flow HTE system was equipped with an inline Raman spectrometer and offline size exclusion chromatography (SEC) to obtain time-dependent conversion and MWD, respectively. Using ML forward models, we first predict monomer conversion, intrinsically learning varying polymerization kinetics that change for each experimental condition. In addition, we predict entire MWDs including the skew and shape as well as SHAP analysis to interpret the dependence on reagent concentrations and reaction time. We then used a transfer learning approach to use the data from our high-throughput flow reactor to predict batch polymerization MWDs with only three additional data points. Overall, we demonstrate that the combination of HTE and ML provides a high level of predictive accuracy in determining polymerization outcomes. Transfer learning can allow exploration outside existing parameter spaces efficiently, providing polymer chemists with the ability to target the synthesis of polymers with desired properties.

PMID:37432764 | DOI:10.1021/acs.jcim.3c00504