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Nevin Manimala Statistics

Equivalence of combined decoction and mixed single decoctions of Gegen Qinlian Decoction in alleviating chemotherapy-associated diarrhea

Zhongguo Zhong Yao Za Zhi. 2023 Jun;48(11):2968-2980. doi: 10.19540/j.cnki.cjcmm.20230329.301.

ABSTRACT

This study compared the chemical profiles, component content, dry paste yield, and pharmacological effects of samples obtained from the mixed single decoctions and the combined decoction of Gegen Qinlian Decoction(GQD), aiming to provide an experimental foundation for evaluating the equivalence of the two decocting methods and the suitability of TCM formula granules in clinical application. The same decoction process was used to prepare the combined decoction and mixed single decoctions of GQD. Ultra-performance liquid chromatography coupled with Q-Exactive Orbitrap mass spectrometry(UPLC-Q-Exactive Orbitrap MS) was employed to compare the chemical profiles between the two groups. High-performance liquid chromatography(HPLC) was used to compare the content of nine characteristic components between the two groups. Then, a delayed diarrhea mouse model induced by irinotecan was established to compare the pharmacological effects of the two groups on chemotherapy-induced diarrhea. The UPLC-Q-Exactive Orbitrap MS in ESI~+ and ESI~- modes identified 59 chemical components in the compound decoction and mixed single decoctions, which showed no obvious differences in component species. The content of baicalin and wogonoside was higher in the compound decoction, while that of puerarin, daidzein-8-C-apiosylglucoside, berberine, epiberberine, wogonin, glycyrrhizic acid, and daidzein was higher in the mixed single decoctions. Further statistical analysis revealed no significant difference in the content of the nine characteristic components between the compound decoction and the mixed single decoctions. The dry paste yield had no significant difference between the two groups. Compared with the model group, both compound decoction and mixed single decoctions alleviated the weight loss and reduced diarrhea index in mice. Both of them lowered the levels of tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), cyclooxygenase-2(COX-2), intercellular adhesion molecule-1(ICAM-1), interleukin-10(IL-10), malondialdehyde(MDA), and nitric oxide(NO) in the colon tissue. Furthermore, they significantly increased the levels of glutathione peroxidase(GSH-Px) and superoxide dismutase(SOD). Hematoxylin-eosin(HE) staining showed that colon tissue cells were tightly arranged with clear nuclei in both groups without obvious difference. The compound decoction and mixed single decoctions showed no significant differences in chemical component species, content of nine characteristic components, dry paste yield, or the pharmacological effects on alleviating chemotherapy-induced diarrhea. The findings provide a reference for evaluating the flexibility and superiority of combined or single decocting method in the preparation of TCM decoctions or formula granules.

PMID:37381957 | DOI:10.19540/j.cnki.cjcmm.20230329.301

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Prothrombin Time and International Normalized Ratio as Predictors of Factor VII Coagulation Activity in Pediatric Patients

Isr Med Assoc J. 2023 Jun;25(6):402-406.

ABSTRACT

BACKGROUND: Factor VII (FVII) deficiency is characterized by normal activated partial thromboplastin time (aPTT) and prolonged prothrombin time (PT) values. It is diagnosed by determining protein level and coagulation activity (FVII:C). FVII:C measurements are expensive and time consuming.

OBJECTIVES: To analyze correlations between PT, international normalized ratio (INR), and FVII:C in pediatric patients before otolaryngology surgery and to establish alternative methods for identifying FVII deficiency.

METHODS: FVII:C data were collected from 96 patients with normal aPTT and prolonged PT values during preoperative otolaryngology surgery coagulation workup between 2016 and 2020. We compared demographic and clinical parameters using Spearman correlation coefficient and receiver operating characteristic (ROC) curve analysis to determine the accuracy of PT and INR values to predict FVII deficiency.

RESULTS: The median values of PT, INR and FVII:C were 13.5 seconds, 1.14, and 67.5%, respectively. In total, 65 participants (67.7%) displayed normal FVII:C compared to 31 (32.3%) with decreased FVII:C. A statistically significant negative correlation was observed between FVII:C and PT values and between FVII:C and INR. Despite statistically significant ROC of 0.653 for PT (P-value = 0.017, 95% confidence interval [95%CI] 0.529-0.776) and 0.669 for INR (P-value = 0.08, 95%CI 0.551-0.788), we were unable to determine an optimal cutoff point to predict FVII:C deficiency with high sensitivity and high specificity.

CONCLUSIONS: We could not identify a PT or INR threshold to best predict clinically relevant FVII:C levels. When PT is abnormal, determining FVII:C protein levels is needed for diagnosing FVII deficiency and considering surgical prophylactic treatment.

PMID:37381933

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Plasma Proteomic Patterns Show Sex Differences in Early Concentric Left Ventricular Remodeling

Circ Heart Fail. 2023 Jun 29:e010255. doi: 10.1161/CIRCHEARTFAILURE.122.010255. Online ahead of print.

ABSTRACT

BACKGROUND: Concentric remodeling (cRM) can precede heart failure with preserved ejection fraction (HFpEF), a condition prevalent in women.

METHODS: Patients (n=60 593, 54.2% women) visiting outpatient clinics of Cardiology Centers of the Netherlands were analyzed for cRM, HFpEF development, and mortality risk. We studied risk factors for relative wall thickness both sex-stratified and in women and men combined. Biomarker profiling was performed (4534 plasma proteins) in a substudy involving 557 patients (65.4% women) to identify pathways involved in cRM.

RESULTS: cRM was present in 23.5% of women and 27.6% of men and associated with developing HFpEF (HR, 2.15 [95% CI, 1.51-2.99]) and mortality risk (HR, 1.09 [95% CI, 1.00-1.19]) in both sexes. Age, heart rate, and hypertension were statistically significantly stronger risk factors for relative wall thickness in women than men. Higher circulating levels of IFNA5 (interferon alpha-5) were associated with higher relative wall thickness in women only. Pathway analysis revealed differential pathway activation by sex and increased expression of inflammatory pathways in women.

CONCLUSIONS: cRM is prevalent in approximately 1 in 4 women and men visiting outpatient cardiology clinics and associated with HFpEF development and mortality risk in both sexes. Known risk factors for cRM were more strongly associated in women than men. Proteomic analysis revealed inflammatory pathway activation in women, with a central role for IFNA5. Differential biologic pathway activation by sex in cRM may contribute to the female predominance of HFpEF and holds promise for identification of new therapeutic avenues for prevention and treatment of HFpEF.

REGISTRATION: URL: https://www.

CLINICALTRIALS: gov; Unique identifier: NCT001747.

PMID:37381923 | DOI:10.1161/CIRCHEARTFAILURE.122.010255

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Nevin Manimala Statistics

Eye blinking, musical processing, and subjective states-A methods account

Psychophysiology. 2023 Jun 29:e14350. doi: 10.1111/psyp.14350. Online ahead of print.

ABSTRACT

Affective sciences often make use of self-reports to assess subjective states. Seeking a more implicit measure for states and emotions, our study explored spontaneous eye blinking during music listening. However, blinking is understudied in the context of research on subjective states. Therefore, a second goal was to explore different ways of analyzing blink activity recorded from infra-red eye trackers, using two additional data sets from earlier studies differing in blinking and viewing instructions. We first replicate the effect of increased blink rates during music listening in comparison with silence and show that the effect is not related to changes in self-reported valence, arousal, or to specific musical features. Interestingly, but in contrast, felt absorption reduced participants’ blinking. The instruction to inhibit blinking did not change results. From a methodological perspective, we make suggestions about how to define blinks from data loss periods recorded by eye trackers and report a data-driven outlier rejection procedure and its efficiency for subject-mean analyses, as well as trial-based analyses. We ran a variety of mixed effects models that differed in how trials without blinking were treated. The main results largely converged across accounts. The broad consistency of results across different experiments, outlier treatments, and statistical models demonstrates the reliability of the reported effects. As recordings of data loss periods come for free when interested in eye movements or pupillometry, we encourage researchers to pay attention to blink activity and contribute to the further understanding of the relation between blinking, subjective states, and cognitive processing.

PMID:37381918 | DOI:10.1111/psyp.14350

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Modeling Emerging Interpersonal Synchrony and its Related Adaptive Short-Term Affiliation and Long-Term Bonding: A Second-Order Multi-Adaptive Neural Agent Model

Int J Neural Syst. 2023 Jun 28:2350038. doi: 10.1142/S0129065723500387. Online ahead of print.

ABSTRACT

When people interact, their behavior tends to become synchronized, a mutual coordination process that fosters short-term adaptations, like increased affiliation, and long-term adaptations, like increased bonding. This paper addresses for the first time how such short-term and long-term adaptivity induced by synchronization can be modeled computationally by a second-order multi-adaptive neural agent model. It addresses movement, affect and verbal modalities and both intrapersonal synchrony and interpersonal synchrony. The behavior of the introduced neural agent model was evaluated in a simulation paradigm with different stimuli and communication-enabling conditions. Moreover, in this paper, mathematical analysis is also addressed for adaptive network models and their positioning within the landscape of adaptive dynamical systems. The first type of analysis addressed shows that any smooth adaptive dynamical system has a canonical representation by a self-modeling network. This implies theoretically that the self-modeling network format is widely applicable, which also has been found in many practical applications using this approach. Furthermore, stationary point and equilibrium analysis was addressed and applied to the introduced self-modeling network model. It was used to obtain verification of the model providing evidence that the implemented model is correct with respect to its design specifications.

PMID:37381917 | DOI:10.1142/S0129065723500387

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Lack of Incremental Prognostic Value of Pericoronary Adipose Tissue Computed Tomography Attenuation Beyond Coronary Artery Disease Reporting and Data System for Major Adverse Cardiovascular Events in Patients With Acute Chest Pain

Circ Cardiovasc Imaging. 2023 Jun 29:e015120. doi: 10.1161/CIRCIMAGING.122.015120. Online ahead of print.

ABSTRACT

BACKGROUND: Pericoronary adipose tissue (PCAT) and Coronary Artery Disease Reporting and Data System (CAD-RADS) category had prognostic values for major adverse cardiovascular events (MACEs). However, little is known about the difference between CAD-RADS and PCAT computed tomography (CT) attenuation for predicting MACEs. This study was to compare the prognostic value of PCAT and CAD-RADS for MACEs in patients with acute chest pain.

METHODS: Between January 2010 and December 2021, all consecutive emergency patients with acute chest pain referred for coronary computed tomography angiography were enrolled in this retrospective study. MACEs included unstable angina requiring hospitalization, coronary revascularization, nonfatal myocardial infarction, and all-cause death. Patients’ clinical characteristics, CAD-RADS, and PCAT CT attenuation were used to evaluate risk factors of MACEs using multivariable Cox regression analysis.

RESULTS: A total of 1313 patients were evaluated (mean age, 57.13±12.57 years; 782 men). During a median follow-up of 38 months, 142 of the 1313 patients (10.81%) experienced MACEs. Multivariable Cox regression analysis showed that CAD-RADS categories 2, 3, 4, 5 (hazard ratio range, 2.286-8.325; all P<0.005) and right coronary artery PCAT CT attenuation (hazard ratio, 1.033; P=0.006) were independent predictors of MACEs after adjusting for clinical risk factors. The C statistics revealed that CAD-RADS improved risk stratification compared with PCAT CT alone (C-index, 0.760 versus 0.712; P=0.036). However, the benefit of right coronary artery PCAT CT attenuation combined with CAD-RADS was not significant compared with CAD-RADS alone (0.777 versus 0.760; P=0.129).

CONCLUSIONS: Right coronary artery PCAT CT attenuation and CAD-RADS were independent predictors of MACEs. However, no incremental prognostic value of right coronary artery PCAT CT attenuation beyond CAD-RADS was detected for MACEs in patients with acute chest pain.

PMID:37381909 | DOI:10.1161/CIRCIMAGING.122.015120

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Vaccine-incentivized blood donation: A survey of public perceptions in Canada

Vox Sang. 2023 Jun 29. doi: 10.1111/vox.13484. Online ahead of print.

ABSTRACT

BACKGROUND AND OBJECTIVES: Canadian blood donations declined during the start of the COVID-19 pandemic. Conversely, vaccine demand outpaced supply during the initial stages of the COVID-19 vaccine rollout in Canada. This study investigates public perceptions regarding vaccine-incentivized blood donation, among COVID-19 and future pandemics, in Canada.

MATERIALS AND METHODS: A 19-question survey was developed and distributed in person and online to Canadians during the third wave of the COVID-19 pandemic. Participants were asked questions about demographics, blood donation eligibility, previous donations and sentiments towards vaccine-incentivized blood donation. Data were analysed using descriptive statistics.

RESULTS: In total, 787 respondents completed the survey with representation from all sexes, ages, races, locations of residence and work employment. Overall, 176 (22%) participants self-identified as working or living in healthcare settings, 511 (65%) were currently able to donate blood products, 247 (31%) previously donated blood and 48 (6%) donated blood during the COVID-19 pandemic. With the exception of ineligible blood donors, many Canadians, particularly previous blood donors, were agreeable with this incentivization proposal. Many participants claimed they would donate blood products for vaccines during COVID-19 and future pandemics but raised concerns about the equitableness of such approach.

CONCLUSION: Vaccine-incentivized blood donation was viewed positively by many Canadians in our study. Future research must investigate the equity and feasibility of this strategy. In the interim, further strategies should be explored to encourage blood donation in Canada.

PMID:37381906 | DOI:10.1111/vox.13484

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Antifungal stewardship in practice: Insights from a prospective audit and feedback program

Infect Control Hosp Epidemiol. 2023 Jun 29:1-5. doi: 10.1017/ice.2023.129. Online ahead of print.

ABSTRACT

OBJECTIVE: To identify characteristics of antifungal prospective audit and feedback (PAF) and to compare rates of PAF recommendation and acceptance between antifungal and antibiotic agents.

DESIGN: Retrospective cohort study of antifungal and antibiotic audits by a children’s hospital antimicrobial stewardship program (ASP) from November 1, 2020, to October 31, 2022.

METHODS: Antimicrobial audit data were retrieved from the ASP data warehouse. We characterized antifungal PAF using descriptive statistics. We then compared the overall rates of PAF recommendation and recommendation acceptance between antifungals and antibiotics. We also compared the differences in antifungal and antibiotic PAF recommendation and acceptance rates across various factors, including infectious problem, medical service, and recommendation type.

RESULTS: Of 10,402 antimicrobial audits identified during the study period, 8,599 (83%) were for antibiotics and 1,803 (17%) were for antifungals. The highest antifungal recommendation rates were for liposomal amphotericin B, antifungals used for sepsis or respiratory tract infection, and antifungals prescribed in the cardiovascular intensive care unit. The rate of PAF recommendation was higher for antibiotics than for antifungals (29% vs 21%; P < .001); however, the rates of recommendation acceptance were similar. Recommendations to discontinue or for medication monitoring were more common for antifungals.

CONCLUSIONS: Our analysis of antifungal PAF identified key opportunities to improve antifungal use, including the optimized use of specific agents and targeted use by certain medical services. Moreover, antifungal PAF, despite identifying fewer recommendations compared to antibiotic PAF, were associated with similarly high rates of acceptance, highlighting a promising opportunity for antifungal stewardship.

PMID:37381887 | DOI:10.1017/ice.2023.129

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Blood glucose, blood pressure, and cholesterol testing among adults with diabetes before and during the COVID-19 pandemic, USA, 2019 vs 2021

BMJ Open Diabetes Res Care. 2023 Jun;11(3):e003420. doi: 10.1136/bmjdrc-2023-003420.

ABSTRACT

INTRODUCTION: Regular blood glucose/A1c, blood pressure (BP), and cholesterol (ABC) testing is important for diabetes management. It is unknown whether pandemic-related disruptions in medical care were negatively associated with ABC testing among US adults with diagnosed diabetes.

RESEARCH DESIGN AND METHODS: A cross-sectional analysis was conducted among adults ≥18 years with diagnosed diabetes who participated in the 2019 or 2021 National Health Interview Survey (n=3355 and n=3127, respectively). Adults with diabetes self-reported sociodemographic and diabetes-related characteristics, ABC testing in the past year, and delays or not getting medical care due to the pandemic (2021 only). Descriptive statistics were used to determine differences in ABC testing in 2019 vs 2021. Logistic regression models were used to assess the association between delays or not getting medical care due to the pandemic and ABC testing, adjusting for sociodemographic characteristics, diabetes duration, and diabetes medication use.

RESULTS: Overall, the prevalence of having a blood glucose/A1c or a BP test in the past year was high (>90%) but it was significantly lower in 2021 compared with 2019 (A1c: 94.2% vs 96.8%, p<0.001; BP: 96.8% vs 98.4%, p=0.002, respectively). Cholesterol testing remained stable (93.0% in 2021 vs 94.5% in 2019, p=0.053). In logistic regression analysis, after full adjustment, adults who reported delaying or not getting medical care when needed due to the pandemic were 50% less likely to get an ABC test in the past year compared with those who promptly received medical care (A1c: adjusted OR (aOR)=0.44, 95% CI 0.29-0.68; BP: aOR=0.48, 95% CI 0.27-0.85; cholesterol: aOR=0.48, 95% CI 0.31-0.75).

CONCLUSIONS: Disruptions in medical care during the pandemic were associated with a decrease in ABC testing. Future research is needed to assess whether blood glucose/A1c and BP testing returns to prepandemic levels and if reductions in these tests result in excess diabetes-related complications.

PMID:37380358 | DOI:10.1136/bmjdrc-2023-003420

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Using human genetics to understand the phenotypic association between chronotype and breast cancer

J Sleep Res. 2023 Jun 28:e13973. doi: 10.1111/jsr.13973. Online ahead of print.

ABSTRACT

Little is known regarding the shared genetic influences underlying the observed phenotypic association between chronotype and breast cancer in women. Leveraging summary statistics from the hitherto largest genome-wide association study conducted in each trait, we investigated the genetic correlation, pleiotropic loci, and causal relationship of chronotype with overall breast cancer, and with its subtypes defined by the status of oestrogen receptor. We identified a negative genomic correlation between chronotype and overall breast cancer ( r g $$ {r}_g $$ = -0.06, p = 3.00 × 10-4 ), consistent across oestrogen receptor-positive ( r g $$ {r}_g $$ = -0.05, p = 3.30 × 10-3 ) and oestrogen receptor-negative subtypes ( r g $$ {r}_g $$ = -0.05, p = 1.11 × 10-2 ). Five specific genomic regions were further identified as contributing a significant local genetic correlation. Cross-trait meta-analysis identified 78 loci shared between chronotype and breast cancer, of which 23 were novel. Transcriptome-wide association study revealed 13 shared genes, targeting tissues of the nervous, cardiovascular, digestive, and exocrine/endocrine systems. Mendelian randomisation demonstrated a significantly reduced risk of overall breast cancer (odds ratio 0.89, 95% confidence interval 0.83-0.94; p = 1.30 × 10-4 ) for genetically predicted morning chronotype. No reverse causality was found. Our work demonstrates an intrinsic link underlying chronotype and breast cancer, which may provide clues to inform management of sleep habits to improve female health.

PMID:37380357 | DOI:10.1111/jsr.13973