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Nevin Manimala Statistics

Novel biomarkers for the assessment of disease activity in patients with sarcoidosis: a case-control study

Sarcoidosis Vasc Diffuse Lung Dis. 2023 Jun 29;40(2):e2023017. doi: 10.36141/svdld.v40i2.14327.

ABSTRACT

BACKGROUND AND AIM: The prognosis of sarcoidosis is challenging and largely depends on the persistence of disease activity and the degree of organ dysfunction. Various biomarkers have been evaluated for diagnosis, disease activity assessment, and prognosis. This study aimed to determine if the ratios of monocytes to high-density lipoprotein cholesterol (MHR), platelets to lymphocytes (PLR), neutrophils to lymphocytes (NLR), and lymphocytes to monocytes ratio (LMR) could be used as novel sarcoidosis activity markers.

METHODS: In a case-control study, 54 patients with biopsy-confirmed sarcoidosis were divided into two groups; group 1: consisted of 27 patients with active sarcoidosis who were newly diagnosed and treatment-naive, and group 2: consisted of 27 patients with inactive sarcoidosis who had been on treatment for at least 6 months. All patients were subjected to a comprehensive history, physical examination, laboratory tests, chest imaging, spirometry, and screening for extrapulmonary organ involvement by means of electrocardiogram and eye examination.

RESULTS: The mean age of the patients was 44 ± 11 years (79.6% were females & 20.4% were males). MHR, NLR, and LMR were significantly higher in patients with active sarcoidosis than in an inactive disease with a cut-off value of 8.6, a sensitivity of 81.5%, and a specificity of 70.4% (P-value < 0.001), a cut-off value of 1.95, sensitivity of 74% and specificity of 66.7% (P-value 0.007) and a cut-off value of < 4, a sensitivity of 81.5%, and a specificity of 85.2% (P-value < 0.001), respectively. In contrast, PLR was not statistically significant between active and inactive sarcoidosis patients.

CONCLUSIONS: The lymphocytes monocytes ratio is a highly sensitive and specific biomarker that could be used to assess the disease activity in sarcoidosis patients.

PMID:37382070 | DOI:10.36141/svdld.v40i2.14327

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Nevin Manimala Statistics

Bayesian multilevel hidden Markov models identify stable state dynamics in longitudinal recordings from macaque primary motor cortex

Eur J Neurosci. 2023 Jun 29. doi: 10.1111/ejn.16065. Online ahead of print.

ABSTRACT

Neural populations, rather than single neurons, may be the fundamental unit of cortical computation. Analysing chronically recorded neural population activity is challenging not only because of the high dimensionality of activity but also because of changes in the signal that may or may not be due to neural plasticity. Hidden Markov models (HMMs) are a promising technique for analysing such data in terms of discrete latent states, but previous approaches have not considered the statistical properties of neural spiking data, have not been adaptable to longitudinal data, or have not modelled condition-specific differences. We present a multilevel Bayesian HMM addresses these shortcomings by incorporating multivariate Poisson log-normal emission probability distributions, multilevel parameter estimation and trial-specific condition covariates. We applied this framework to multi-unit neural spiking data recorded using chronically implanted multi-electrode arrays from macaque primary motor cortex during a cued reaching, grasping and placing task. We show that, in line with previous work, the model identifies latent neural population states which are tightly linked to behavioural events, despite the model being trained without any information about event timing. The association between these states and corresponding behaviour is consistent across multiple days of recording. Notably, this consistency is not observed in the case of a single-level HMM, which fails to generalise across distinct recording sessions. The utility and stability of this approach is demonstrated using a previously learned task, but this multilevel Bayesian HMM framework would be especially suited for future studies of long-term plasticity in neural populations.

PMID:37382060 | DOI:10.1111/ejn.16065

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Nevin Manimala Statistics

Additional benefits of titanium platelet-rich fibrin (T-PRF) with a coronally advanced flap (CAF) for recession coverage: A case series

Dent Med Probl. 2023 Apr-Jun;60(2):279-285. doi: 10.17219/dmp/141919.

ABSTRACT

BACKGROUND: Platelet concentrates (PCs) are a boon in the field of dentistry. Various generations of PCs have been tried and utilized in different treatment methods, such as intrabony defect therapy, root coverage procedures, oral surgical procedures, and palatal wound healing. Titanium-prepared platelet-rich fibrin (T-PRF) is a third-generation PC that is prepared in medical-grade titanium tubes and achieves good healing in the field of periodontics.

OBJECTIVES: Not many studies have been performed utilizing T-PRF in the treatment of gingival recession (GR). The present case series study aimed to evaluate the efficacy of T-PRF in the treatment of Cairo’s Type 1 GR defects.

MATERIAL AND METHODS: A total of 20 patients with 34 Cairo’s Type 1 GR defects were recruited. The surgical sites were treated using the trapezoidal coronally advanced flap (CAF) technique and T-PRF as a biomaterial underneath the flap. The plaque index (PI) and the gingival index (GI), recession depth (RD) and recession width (RW), as well as the width of keratinized tissue (WKT), were measured at baseline and 6 months postoperatively. The obtained values were subjected to statistical analysis. The values were presented as mean (M) and standard deviation (SD), the paired t test was performed to measure all the parameters, and a p-value <0.05 was considered to be statistically significant.

RESULTS: The changes observed 6 months after the use of T-PRF were non-significant for PI (p = 0.053) and significant for GI (p = 0.016) as compared to the baseline. Significant reductions (p < 0.001) were noted for RD and RW, as well as a significant increase in WKT and a mean root coverage (MRC) of 91%.

CONCLUSIONS: Titanium-prepared platelet-rich fibrin can be used as a biomaterial for the treatment of GR defects, as it eliminates the possible silica contamination, as in the case of leukocyte-platelet-rich fibrin (L-PRF), and the need for a second surgical site, as with subepithelial connective tissue graft (SCTG). Moreover, the use of T-PRF results in a thicker membrane formation, and titanium tubes can be reused after proper sterilization.

PMID:37382053 | DOI:10.17219/dmp/141919

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Implementation of a Best Practice Advisory to Improve Infection Screening Prior to New Prescriptions of Biologics and Targeted Synthetic Drugs

Arthritis Care Res (Hoboken). 2023 Jun 29. doi: 10.1002/acr.25181. Online ahead of print.

ABSTRACT

OBJECTIVE: Use of biologic and targeted synthetic DMARDs (b/tsDMARDs) in patients with pre-existing tuberculosis (TB), hepatitis B virus (HBV), or hepatitis C virus (HCV) infection can have serious consequences. Although various society guidelines recommend routine screening for these infections prior to initiating certain b/tsDMARDs adherence to these recommendations varies widely. This quality improvement initiative evaluated local compliance with screening and assessed if automated computerized decision support system (CDSS) in the form of a best practice advisory (BPA) in the electronic health record could improve patient screening.

METHODS: Established patients with autoimmune rheumatic disease (ARD) aged 18 years or older with at least one visit to our rheumatology practice between 10/1/2017 and 3/3/2022 were included. When prescribing a new b/tsDMARD, clinicians were alerted via a BPA that showed the most recent results for TB, HBV, and HCV. Screening proportions for TB, HBV, and HCV before BPA initiation were compared with those of eligible patients after the BPA implementation.

RESULTS: A total of 711 patients pre-BPA and 257 patients post-BPA implementation were included in the study. The BPA implementation was associated with statistically significant improvement in screening for TB from 66% to 82% (p=<0.001), HCV from 60 to 79% (p=<0.001), hepatitis B core antibody (HBcAb) 32% to 51% (p=<0.001), and hepatitis B surface antigen (HBsAg) from 51% to 70% (p=<0.001).

CONCLUSION: Implementation of a BPA can improve infectious disease screening for patients with ARD who are started on b/tsDMARD and has potential to improve patient safety. This article is protected by copyright. All rights reserved.

PMID:37382043 | DOI:10.1002/acr.25181

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Nevin Manimala Statistics

Geographic variation in HCV treatment penetration among people who inject drugs in Baltimore, MD

J Viral Hepat. 2023 Jun 29. doi: 10.1111/jvh.13864. Online ahead of print.

ABSTRACT

We evaluated geographic heterogeneity in hepatitis C virus (HCV) treatment penetration among people who inject drug (PWID) across Baltimore, MD since the advent of direct-acting antivirals (DAAs) using space-time clusters of HCV viraemia. Using data from a community-based cohort of PWID, the AIDS Linked to the IntraVenous Experience (ALIVE) study, we identified space-time clusters with higher-than-expected rates of HCV viraemia between 2015 and 2019 using scan statistics. We used Poisson regression to identify covariates associated with HCV viraemia and used the regression-fitted values to detect adjusted space-time clusters of HCV viraemia in Baltimore city. Overall, in the cohort, HCV viraemia fell from 77% in 2015 to 64%, 49%, 39% and 36% from 2016 to 2019. In Baltimore city, the percentage of census tracts where prevalence of HCV viraemia was ≥85% dropped from 57% to 34%, 25%, 22% and 10% from 2015 to 2019. We identified two clusters of higher-than-expected HCV viraemia in the unadjusted analysis that lasted from 2015 to 2017 in East and West Baltimore and one adjusted cluster of HCV viraemia in West Baltimore from 2015 to 2016. Neither differences in age, sex, race, HIV status, nor neighbourhood deprivation were able to explain the significant space-time clusters. However, residing in a cluster with higher-than-expected viraemia was associated with age, sex, educational attainment and higher levels of neighbourhood deprivation. Nearly 4 years after DAAs became available, HCV treatment has penetrated all PWID communities across Baltimore city. While nearly all census tracts experienced improvements, change was more gradual in areas with higher levels of poverty.

PMID:37382024 | DOI:10.1111/jvh.13864

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Nevin Manimala Statistics

Medication rules of traditional Chinese medicine compounds for pain

Zhongguo Zhong Yao Za Zhi. 2023 Jun;48(12):3386-3393. doi: 10.19540/j.cnki.cjcmm.20230311.501.

ABSTRACT

The present study collected data on traditional Chinese medicine(TCM) compounds effective in relieving pain from the patent database of the State Intellectual Property Office(SIPO), sorted out the TCM compounds against pain in patents, and analyzed the medication rules to provide references for the research and development of new TCM drugs against pain. The data were subjected to frequency statistics, association rules, cluster analysis, and complex network analysis by IBM SPSS Modeler 18.3 and SPSS Statistical 26.0. The results showed that among the 101 oral prescriptions included in the statistics, the top 5 drugs were Glycyrrhizae Radix et Rhizoma, Angelicae Sinensis Radix, Paeoniae Radix Alba, Chuanxiong Rhizoma, and Salviae Miltiorrhizae Radix et Rhizoma, and among the 49 external prescriptions included in the statistics, the top 5 drugs were Myrrha, Olibanum, Angelicae Dahuricae Radix, Borneolum Syntheticum, and Chuanxiong Rhizoma. Whether oral or external prescriptions, the drugs were mainly warm in nature, and bitter, pungent, and sweet in flavor. According to TCM complex network analysis, the core drugs were Glycyrrhizae Radix et Rhizoma, Angelicae Sinensis Radix, Paeoniae Radix Alba, and Chuanxiong Rhizoma in oral prescriptions, and Olibanum, Myrrha, Glycyrrhizae Radix et Rhizoma, Chuanxiong Rhizoma, and Angelicae Sinensis Radix in external prescriptions. Overall, the therapeutic principles of oral prescriptions were mainly replenishing Qi, nourishing blood, and promoting Qi and blood circulation, while those of external prescriptions were activating blood, resolving stasis, promoting Qi flow, and relieving pain on the basis of the oral prescriptions. In the future research and development of TCM compounds against pain, the prescriptions should be modified with mind-tranquilizing and depression-relieving drugs. With the modernization of TCM, the development of new pain-relieving TCM compound patents based on ancient methods and clinical experience adhering to the guidance of TCM treatment based on syndrome differentiation can meet the new demand for pain treatment in the current society and give full play to the advantages of TCM in pain treatment.

PMID:37382021 | DOI:10.19540/j.cnki.cjcmm.20230311.501

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Nevin Manimala Statistics

Difference in liver injury induced by dictamnine between males and females: based on untargeted metabolomics

Zhongguo Zhong Yao Za Zhi. 2023 Jun;48(12):3317-3326. doi: 10.19540/j.cnki.cjcmm.20230119.401.

ABSTRACT

In recent years, reports of adverse reactions related to traditional Chinese medicine(TCM) have been on the rise, especially some traditionally considered &quot;non-toxic&quot; TCM(such as Dictamni Cortex). This has aroused the concern of scholars. This study aims to explore the metabolomic mechanism underlying the difference in liver injury induced by dictamnine between males and females through the experiment on 4-week-old mice. The results showed that the serum biochemical indexes of liver function and organ coefficients were significantly increased by dictamnine(P&lt;0.05), and hepatic alveolar steatosis was mainly observed in female mice. However, no histopathological changes were observed in the male mice. Furthermore, a total of 48 differential metabolites(such as tryptophan, corticosterone, and indole) related to the difference in liver injury between males and females were screened out by untargeted metabolomics and multivariate statistical analysis. According to the receiver operating characteristic(ROC) curve, 14 metabolites were highly correlated with the difference. Finally, pathway enrichment analysis indicated that disorders of metabolic pathways, such as tryptophan metabolism, steroid hormone biosynthesis, and ferroptosis(linoleic acid metabolism and arachidonic acid metabolism), may be the potential mechanism of the difference. Liver injury induced by dictamnine is significantly different between males and females, which may be caused by the disorders of tryptophan metabolism, steroid hormone biosynthesis, and ferroptosis pathways.

PMID:37382016 | DOI:10.19540/j.cnki.cjcmm.20230119.401

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Manufacturing classification system for oral solid dosage forms of traditional Chinese medicines(Ⅰ): classification of processing routes

Zhongguo Zhong Yao Za Zhi. 2023 Jun;48(12):3169-3179. doi: 10.19540/j.cnki.cjcmm.20221014.301.

ABSTRACT

Oral solid dosage(OSD) occupies a key position in the market of Chinese patent medicines and new traditional Chinese medicines. Processing route is the foundation for the research and development of traditional Chinese medicine OSDs. On the basis of prescriptions and preparation methods of 1 308 traditional Chinese medicine OSDs recorded in the Chinese Pharmacopoeia, we summarized the patterns of processing routes of both modern dosage forms(tablets, granules, and capsules) and traditional dosage forms(pills and powder) and constructed a manufacturing classification system(MCS) based on the processing routes. Based on the MCS, statistical analyses were conducted respectively on medicinal materials, pharmaceutical excipients, extraction solvents in the pretreatment process, crushed medicinal materials, methods of concentration and purification, and methods of drying and granulation, aiming to uncover the process features. The results showed that each dosage form can be prepared via different routes with different processing methods of decoction pieces and raw materials for dosage preparation. The raw materials for dosage form preparation of traditional Chinese medicine OSDs included total extract, semi-extract, and total crushed powder, which accounted for different proportions. The raw materials for traditional dosage forms are mainly decoction pieces powder. Semi-extracts are the main raw materials for tablets and capsules, which account for 64.8% and 56.3%, respectively. Total extracts are the main raw materials for granules, with a proportion of 77.8%. Compared with tablets and capsules, traditional Chinese medicine granules with dissolubility requirements had a larger proportion of water extraction process, a higher proportion of refining process(34.7%), and a lower proportion of crushed medicinal mate-rials in semi-extract granules. There are four ways to add volatile oil to the modern dosage forms of traditional Chinese medicine. In addition, some new technologies and processes have been used in concentration, filtration, and granulation processes of traditional Chinese medicine OSDs, and the application of pharmaceutical excipients is diversified. The results of this study are expected to provide reference for the processing route design and upgrading of OSDs for new traditional Chinese medicines.

PMID:37382000 | DOI:10.19540/j.cnki.cjcmm.20221014.301

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Quality evaluation of Huocao based on UPLC fingerprint and multi-component content determination

Zhongguo Zhong Yao Za Zhi. 2023 Jun;48(11):3000-3013. doi: 10.19540/j.cnki.cjcmm.20230218.201.

ABSTRACT

Huocao(a traditional Chinese herbal medicine) moxibustion is a characteristic technology in Yi medicine suitable for cold-dampness diseases. Huocao, as the moxibustion material, is confusedly used in clinical practice and little is known about its quality control. In this study, UPLC method was used to establish the chemical fingerprint of non-volatile components in Huocao, and the contents of eight phenolic acids such as chlorogenic acid were determined. Multivariate statistical analysis was performed to obtain the indicator components of Huocao for quality evaluation, and thus a comprehensive evaluation system for the quality of Huocao was built. The UPLC fingerprints of 49 batches of Huocao were established, and there were 20 common peaks, of which eight phenolic acids including neochlorogenic acid and chlorogenic acid were identified. Except for three batches of Huocao, the similarity of the other 46 batches was higher than 0.89, suggesting that the established fingerprint method could be used for quality control of the medicinal herb. The correlation coefficient between entropy weight score of the eight phenolic acids and comprehensive fingerprint score in Huocao was 0.875(P&lt;0.01), which indicated that the eight phenolic acids could be used as indicator components for the quality evaluation of Huocao. Furthermore, in multivariate statistical analysis on the common peaks of fingerprint and the contents of the eight phenolic acids, chlorogenic acid, isochlorogenic acid A and isochlorogenic acid C were screened to be the indicator components. The results revealed that the proposed method achieved a simple and accurate quality control of Huocao based on UPLC fingerprint and multi-component content determination, which provided useful data for establishing the quality standard of Huocao.

PMID:37381974 | DOI:10.19540/j.cnki.cjcmm.20230218.201

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CiteSpace knowledge map of research hotspots and frontiers of traditional Chinese medicine intervention in psoriasis in recent ten years

Zhongguo Zhong Yao Za Zhi. 2023 Jun;48(11):3110-3117. doi: 10.19540/j.cnki.cjcmm.20230224.501.

ABSTRACT

This study aimed to investigate the development status of traditional Chinese medicine(TCM) intervention in psoriasis in recent ten years, analyze the research hotspots, and summarize the development trends to provide reference materials for scholars in this field. Taking the available literature related to the field of TCM intervention in psoriasis as the research object, the trends, contents, and source publications were statistically analyzed based on bibliometrics. The research cooperation and co-occurrence of keywords in this field were studied by the knowledge map analysis method based on CiteSpace. The total number of Chinese papers was 2 993 and English papers 285. In terms of publication trend, the annual publication of English papers was low but showed an obvious upward trend, while the increase in Chinese papers fluctuated and tended to be flat. In terms of the content of Chinese papers published, TCM ranked first according to the discipline(2 415). In English papers, the number of publications in pharmacology and pharmaceutical science was the highest(87). Literature source analysis showed that the Chinese and English journals with the most publications were China Journal of Traditional Chinese Medicine and Pharmacy and Evidence Based Complementary and Alternative Medicine, respectively. Beijing University of Chinese Medicine published the most dissertations in China(99). The authors with the most publications in Chinese and English were LI Bin(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine) and LU Chuan-jian(Guangdong Hospital of Traditional Chinese Medicine). As revealed by the CiteSpace analysis of the research cooperation network, there were four mature and stable core teams in this field, but the cooperation intensity between different teams was weak. According to the keywords co-occurrence knowledge graph constructed by CiteSpace, the current hot keywords in this field are as follows: psoriasis, blood-heat syndrome, blood-stasis syndrome, fire needle, blood-dryness type, imiquimod, TCM bath, etiology and pathogenesis, cytokines, cupping therapy, etc. In summary, Chinese scholars have conducted active exploration and research in the field of TCM intervention in psoriasis in recent ten years. The overall development trend is good, and the breadth and depth of the research are constantly extending. It is suggested that relevant research should be free from discipline restrictions and strive for interdisciplinary integration.

PMID:37381969 | DOI:10.19540/j.cnki.cjcmm.20230224.501