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Nevin Manimala Statistics

Efficacy of peripheral arterial access for peripheral blood stem cells collection

J Clin Apher. 2021 Sep 24. doi: 10.1002/jca.21940. Online ahead of print.

ABSTRACT

BACKGROUND: Transplantation of peripheral blood stem cells (PBSCs) mobilized by cytokines is increasingly applied to treat patients with hematologic diseases, such as lymphoma, multiple myeloma, leukemia, etc. Successful hematopoietic stem cell transplantation (HSCT) increasingly depends on the collection of hematopoietic stem cells (HSCs) from peripheral blood. Peripheral vein (PV) is the most common type of blood access. When the blood vessels are not well filled and the blood flow is insufficient, the machine will appear repeated low pressure alarm or pipeline coagulation, which seriously affects the collection efficiency. A peripheral artery (PA) is utilized for drawing blood, while a peripheral vein is used for blood return, that is a way to perform apheresis. The advantages of PA are that it ensures adequate extracorporeal circulation blood flow, stable blood flow rate, simple operation, and relatively low price. However, there are very few studies on the efficacy of peripheral arterial access for HSCs collection. Therefore, this retrospective study was conducted to assess the effectiveness of PA and PV access for PBSCs collection.

METHODS: We performed a retrospective analysis of 150 apheresis procedures on 26 patients and 95 healthy donors collected by PV or PA access from March 1, 2020 to March 1, 2021. We compared the CD34+ cell count, collection efficiency (CE), duration of processing a single blood volume, number of low-pressure alarms, average blood flow rate and number of punctures between the two groups. Also, we analyzed adverse events.

RESULTS: There was no significant difference in the quality of apheresis blood components between the PA group and the PV group. The CD34+ cells collected was 274.16 ± 216.31 × 106 in the PV group and 246.63 ± 127.94 × 106 in the PA group. The CE in the PA group was 49.50 ± 9.88%, higher than 42.39 ± 14.62% in the PV group. The duration of processing a single blood volume was 90.67 ± 15.35 min in the PV group and 79.68 ± 10.28 min in the PA group. The number of low-pressure alarms in the PA group was 0.38 ± 0.98, <2.42 ± 1.76 in the PV group, and the average blood flow rate in the PA group was 59.27 ± 2.18, higher than 54.21 ± 3.41 in the PV group. The difference was statistically significant (P < .05). The Number of punctures was 1.35 ± 0.75 in the PA group and 1.41 ± 1.01 in the PV group. There was no statistically significant difference.

CONCLUSION: Peripheral artery is a safe, reliable, economical, convenient, and fast vascular access, which opens a new way to the establishment of vascular access for PBSCs collection.

PMID:34558738 | DOI:10.1002/jca.21940

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N-6 methylation-related lncRNA is potential signature in lung adenocarcinoma and influences tumor microenvironment

J Clin Lab Anal. 2021 Sep 24:e23951. doi: 10.1002/jcla.23951. Online ahead of print.

ABSTRACT

BACKGROUND: N-6 methylation (m6A) pushes forward an immense influence on the occurrence and development of lung adenocarcinoma (LUAD). However, the methylation on non-coding RNA in LUAD, especially long non-coding RNA (lncRNA), has not been received sufficient attention.

METHODS: Spearman correlation analysis was used to screen lncRNA correlated with m6A regulators expression from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) repositories, respectively. Then, the least absolute shrinkage and selection operator (LASSO) was applied to build a risk signature consisting m6A-related lncRNA. Univariate and multivariate independent prognostic analysis were applied to evaluate the performance of signature in predicting patients’ survival. Next, we applied Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and gene set enrichment analysis (GSEA) to conduct pathway enrichment analysis of 3344 different expression genes (DEGs). Finally, we set up a competing endogenous RNAs (ceRNA) network to this lncRNA.

RESULTS: A total of 85 common lncRNAs were selected to acquire the components related to prognosis. The final risk signature established by LASSO regression contained 11 lncRNAs: ARHGEF26-AS1, COLCA1, CRNDE, DLGAP1-AS2, FENDRR, LINC00968, TMPO-AS1, TRG-AS1, MGC32805, RPARP-AS1, and TBX5-AS1. M6A-related lncRNA risk score could predict the prognostic of LUAD and was significantly associated with clinical pathological. And in the evaluation of lung adenocarcinoma tumor microenvironment (TME) by using ESTIMATE algorithm, we found a statistically significant correlation between risk score and stromal/immune cells.

CONCLUSION: M6A-related lncRNA was a potential prognostic and therapy target for lung adenocarcinoma.

PMID:34558724 | DOI:10.1002/jcla.23951

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Validation of blood gas analysis in arteriovenous fistula for hemodialysis

Semin Dial. 2021 Sep 24. doi: 10.1111/sdi.13022. Online ahead of print.

ABSTRACT

INTRODUCTION: Arterial blood gas analysis is a minimally invasive technique used in our daily practice but is not a complication free technique. The aim of this study was to validate results from blood gas analysis obtained from the arteriovenous fistula (AVF)/graft as a surrogate marker of the arterial blood gas analysis.

METHODS: A prospective observational study was made in 45 patients. We performed arterial and AVF/graft blood gas analysis and results were compared by a paired sample t Student test.

RESULTS: Most of our subjects was male (68.9%) and the mean age was 67 years (±14). Hemodialysis vintage was 63 months (±66), and vascular access age was 62 months (±56). The more prevalent vascular access was left radiocephalic AVF (n = 16; 35.6%) and the main puncture artery was right radial artery (n = 27; 60.0%). There were no statistically significant differences between the samples collected.

CONCLUSIONS: Our results suggest a possible alternative of arterial blood gas analysis in AVF/graft for hemodialysis patients. This could result in making an uncomfortable procedure almost painless and reducing complications. Future research should take place to include anatomical characteristics of the AVF or the circulation of recirculation.

PMID:34558726 | DOI:10.1111/sdi.13022

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Stroke hospitalizations, posttraumatic stress disorder, and 9/11-related dust exposure: Results from the World Trade Center Health Registry

Am J Ind Med. 2021 Oct;64(10):827-836. doi: 10.1002/ajim.23271. Epub 2021 Jul 19.

ABSTRACT

BACKGROUND: Few studies have examined the association between disaster-related factors and stroke by subtype or number. We investigated the association between 9/11-related posttraumatic stress disorder (PTSD), dust exposure, and stroke subtype as well as recurrent strokes.

METHODS: The study included 29,012 individuals enrolled in the World Trade Center Health Registry. Stroke cases were obtained by matching Registry enrollees to the New York State Department of Health’s discharge records for inpatient visits between 2000 and 2016. Cox proportional hazards regression models were performed to examine the association between 9/11-related risk factors and stroke by subtype. Multinomial logistic regression models were conducted to assess the associations between the same risk factors and the number of stroke hospitalizations.

RESULTS: Having PTSD significantly increased the risk of developing ischemic and hemorrhagic stroke, with adjusted hazards ratios (AHRs) of 1.64 (95% confidence interval [CI]: 1.28-2.10) and 1.73 (95% CI: 1.10-2.71), respectively. The point estimate for dust cloud exposure, although not significant statistically, suggested an increased risk of ischemic stroke (AHR = 1.20, 95% CI: 0.96-1.50). PTSD was significantly associated with recurrent strokes with an adjusted odds ratio of 1.79 (95% CI: 1.09-2.95).

CONCLUSIONS: PTSD is a risk factor for both ischemic and hemorrhagic stroke and is associated with recurrent strokes. Dust exposure on 9/11 is a possible risk factor for ischemic stroke but not for hemorrhagic stroke, and was not associated with recurrent strokes. Our findings warrant additional research on stroke-morbidity and mortality associated with 9/11-related PTSD and dust exposure.

PMID:34558721 | DOI:10.1002/ajim.23271

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The Place and Prognostic Value of TERT Promoter Mutation in Molecular Classification in Grade II-III Glial Tumors and Primary Glioblastomas

Turk Patoloji Derg. 2021 Sep 24. doi: 10.5146/tjpath.2021.01555. Online ahead of print.

ABSTRACT

OBJECTIVE: Diffuse gliomas, the most common primary malignant brain tumors, have been classified by the World Health Organization as class II-IV gliomas. After 2016, two mutations in the promoter region of the telomerase reverse transcriptase (TERT) gene were identified in addition to the IDH, 1p / 19q, and ATRX status.

MATERIAL AND METHOD: We identified 84 patients with grade II-IV glioma with IDH, ATRX, 1p / 19q and TERT status. All tumor samples were subjected to molecular genetic screening (Sanger sequencing for IDH and TERT mutations, fluorescence in situ hybridization for 1p/19q status) after histological diagnosis (immunohistochemistry for IDH1 R132H, ATRX, and p53) for a more precise molecular diagnosis. The confidence intervals were calculated at the 95% confidence level, and differences at p < 0.05 were considered statistically significant.

RESULTS: Primary glioblastomas had the highest frequency of TERT promoter mutations (25 of 28, 89.2%, p=0.006) followed by oligodendrogliomas (29 of 35, 82.8%, p < 0.001) while astrocytomas showed the lowest frequency (3 of 15, 20%, p=0.107), and the positivity significantly differed among these three groups (p < 0.001). TERT promoter mutations were more frequent in patients older than 55 years of age at diagnosis (p=0.023). The group with TERT promoter mutations, and without IDH mutations showed the worst overall survival. However, the presence of both TERT promoter and IDH mutations, which resembled oligodendroglial progression, showed best overall survival (p=0.042).

CONCLUSION: The discovery of TERT promoter mutations in numerous gliomas has opened the door for a better molecular classification of gliomas, and TERT status is associated with survival. Further studies will help in elucidating the value of TERT promoter mutations as biomarkers in clinical practice, and eventual therapeutic targets.

PMID:34558656 | DOI:10.5146/tjpath.2021.01555

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Evaluation of medullary cytokine expression and clinical and laboratory aspects in severe human visceral leishmaniasis

Parasite Immunol. 2021 Sep 24:e12880. doi: 10.1111/pim.12880. Online ahead of print.

ABSTRACT

BACKGROUND: Visceral leishmaniasis (VL) is a serious public health problem. The factors that can determine whether VL develops and progresses to severe form have not been fully identified, but a specific cellular immune response appears to play a key role. Therefore, understanding immunopathogenesis can be useful in preventing a serious clinical outcome.

MATERIALS AND METHODS: Bone marrow samples were collected from patients with severe (SVL) or non-severe VL (NSVL). Cytokine levels and parasitic load were analyzed by RT-qPCR. There is a statistically significant difference in the leukocyte parameter in patients with SVL and NSVL compared to the control patients (p=0.006 and p=0.014, respectively).

RESULTS: Urea, alanine transaminase and albumin parameters had a significant difference p=0.036, p=0.039 and p=0.017, respectively, between SVL and NSVL. Although high levels of IFN-γ, IL-10, IL-6 and TNF-α were present in all groups of individuals with VL, they were not statistically associated with severity. In patients with active VL, IFN-γ and IL-10 were associated, respectively, with a reduction and increase in the parasite load, strong and significant positive association between IFN-γ and IL-10 (rho=0.627 and p=0.003).

CONCLUSION: This study demonstrates that VL stimulates an non-dichotomized inflammatory response between Th1/Th2 and that bone marrow is an important tissue for immune regulation.

PMID:34558674 | DOI:10.1111/pim.12880

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The PRECISE-DAPT score and five-year outcomes after percutaneous coronary intervention: a large-scale, real-world study from China

Eur Heart J Qual Care Clin Outcomes. 2021 Sep 24:qcab068. doi: 10.1093/ehjqcco/qcab068. Online ahead of print.

ABSTRACT

AIMS: The PRECISE-DAPT score is recommended by guidelines for predicting out-of-hospital bleeding in patients after percutaneous coronary intervention (PCI). However, the long-term prognostic value of the PRECISE-DAPT score in patients after PCI remains unclear.

METHODS AND RESULTS: We performed a prospective study of 10,724 patients who underwent PCI throughout 2013 in Fuwai hospital. The bleeding endpoint was Bleeding Academic Research Consortium 2, 3, or 5 bleeding. The ischaemic endpoints were all-cause death and major adverse cardiovascular and cerebrovascular events (MACCE). After a 5-year follow-up, 10,109 patients were finally analysed. A total of 415 (4.11%) patients experienced bleeding, 364 (3.60%) experienced all-cause death, and 2049 (20.27%) had MACCE. Using Cox regression, the risk of bleeding (hazard ratio [HR]: 1.721, 95% confidence interval [CI]: 1.180-2.511, P = 0.005), MACCE (HR: 1.607, 95% CI: 1.347-1.917, P < 0.001), and all-cause-death (HR: 3.902, 95% CI: 2.916-5.221, P < 0.001) in patients with a high score were significantly higher than those in patients with a low score. The PRECISE-DAPT score showed prognostic value for 5-year events of bleeding (C statistic: 0.566, 95% CI: 0.537-0.594), MACCE (C statistic: 0.540, 95% CI: 0.527-0.553), and all-cause-death (C statistic: 0.673, 95% CI: 0.644-0.702).

CONCLUSION: After 5 years of follow-up, the PRECISE-DAPT score has a statistically significant predictive value for long-term bleeding events in Chinese PCI population, and also had some prognostic value for death and MACCE.

PMID:34558620 | DOI:10.1093/ehjqcco/qcab068

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The short-term impact of standardised packaging on smoking and snus use in Norway

Nicotine Tob Res. 2021 Sep 24:ntab194. doi: 10.1093/ntr/ntab194. Online ahead of print.

ABSTRACT

INTRODUCTION: Standardised packaging on tobacco products was required in Norway July 1, 2018. We report pre-registered analyses of the potential impact on daily smoking and on daily snus use among women and men.

METHODS: Interrupted time series (segmented regression) on repeated cross-sectional surveys (2012 to 2019) from two sources: probability samples (Registry Sample, N=46,957) and market research samples (Market Research Sample, N=64,465) of Norwegian adults aged 16 to 79. Self-reported daily smoking and snus use were regressed on a step change impact variable, controlled for trend and demographics (sex, age, region, and education based on national registers in the Registry Sample, and self-reported in the Market Research Sample).

RESULTS: There were tendencies of a decline in smoking (Odds Ratio [OR]=0.94; 95% confidence interval [CI]=0.87, 1.02; lower-tail p-value [Plower]=0.07), and women’s snus use (OR= 0.89; CI=0.77, 1.03; Plower=0.06), but not men’s snus use (OR=1.01; CI=0.92, 1.11; Plower=0.59). Analyses using only the Registry Sample did not detect declines in smoking (OR=0.99; CI=0.88, 1.11; Plower=0.43) or women’s snus use (OR=0.99; CI=0.80, 1.24]; Plower=0.48), and indicated no decline in men’s snus use (OR=1.18; CI=1.03, 1.35; Plower=0.99). Exploratory analyses suggested potential acceleration of the declining trend in smoking (change in trends, OR=0.97) and of the increasing trend in men’s snus use (OR=1.03).

CONCLUSIONS: The analyses indicate that standardised packaging in Norway did not produce a decline in men’s snus use. Results are inconclusive regarding smoking and women’s snus use. Exploratory analyses indicated a decrease in smoking and an increase in men’s snus use.

IMPLICATIONS: -We could not confirm or disconfirm whether standardised packaging is an effective tobacco control measure in a Norwegian context.-According to our analyses, standardized packaging may have effects on smoking prevalence and women’s snus use, but is unlikely to reduce men’s snus use.-The present results may reflect higher effectiveness of standardised packaging for products with stronger health warnings.-As the results varied according to samples and outcomes, the study underlines the importance of pre-registering future analyses on this topic.-Future confirmatory research should test models of gradual impact of standardised packaging.

PMID:34558626 | DOI:10.1093/ntr/ntab194

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Correction: Spatiotemporal distribution and speciation of silver nanoparticles in the healing wound

Analyst. 2021 Sep 24. doi: 10.1039/d1an90083h. Online ahead of print.

ABSTRACT

Correction for ‘Spatiotemporal distribution and speciation of silver nanoparticles in the healing wound’ by Marco Roman et al., Analyst, 2020, 145, 6456-6469, DOI: 10.1039/D0AN00607F.

PMID:34558571 | DOI:10.1039/d1an90083h

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Main drivers of (poly)phenol effects on human health: metabolite production and/or gut microbiota-associated metabotypes?

Food Funct. 2021 Sep 24. doi: 10.1039/d1fo02033a. Online ahead of print.

ABSTRACT

Despite the high human interindividual variability in response to (poly)phenol consumption, the cause-and-effect relationship between some dietary (poly)phenols (flavanols and olive oil phenolics) and health effects (endothelial function and prevention of LDL oxidation, respectively) has been well established. Most of the variables affecting this interindividual variability have been identified (food matrix, gut microbiota, single-nucleotide-polymorphisms, etc.). However, the final drivers for the health effects of (poly)phenol consumption have not been fully identified. At least partially, these drivers could be (i) the (poly)phenols ingested that exert their effect in the gastrointestinal tract, (ii) the bioavailable metabolites that exert their effects systemically and/or (iii) the gut microbial ecology associated with (poly)phenol metabolism (i.e., gut microbiota-associated metabotypes). However, statistical associations between health effects and the occurrence of circulating and/or excreted metabolites, as well as cross-sectional studies that correlate gut microbial ecologies and health, do not prove a causal role unequivocally. We provide a critical overview and perspective on the possible main drivers of the effects of (poly)phenols on human health and suggest possible actions to identify the putative actors responsible for the effects.

PMID:34558584 | DOI:10.1039/d1fo02033a