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Adherence of obstructive sleep apnoea syndrome patients to positive airway pressure therapy – 10-year follow-up

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2021 Jul 2. doi: 10.5507/bp.2021.041. Online ahead of print.

ABSTRACT

PURPOSE: Continuous positive airway pressure (CPAP) is the most effective therapy for obstructive sleep apnoea syndrome (OSAS). Long-term adherence is necessary; however, it may be widely variable based on current literature, where the predicting factors are also not well defined. The aim of this study was to assess ten-year adherence to CPAP and to define factors influencing it.

METHODS: In total, 107 patients (91 males) were enrolled in this study, with an average age of 53.5 years (SD 10.1), with CPAP therapy being indicated (Apnoea-Hypopnoea Index – AHI > 15). Anthropometric and social status data have been obtained as well as the average use of CPAP through device memory.

RESULTS: Sufficient adherence (> 4 hours per night) was found in 57% of patients in the first year with no subsequent significant change during the next 9 years. Adherence correlated significantly with the severity of OSAS – AHI (r = 0.321 over 5 years) and Epworth Sleepiness Scale (r = 0.317 over ten years) but did not correlate with the pressure used or the age of the patient. No statistically significant differences have been found between the sexes, the different mask groups, or the social status groups.

CONCLUSION: Good adherence to CPAP therapy in OSAS patients is essential. According to our results, patients with more severe OSAS or more severe sleepiness seem to have better adherence.

PMID:34282803 | DOI:10.5507/bp.2021.041

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Prevention of COVID-19 by mRNA-based vaccines within the general population of California

Clin Infect Dis. 2021 Jul 20:ciab640. doi: 10.1093/cid/ciab640. Online ahead of print.

ABSTRACT

BACKGROUND: Estimates of COVID-19 vaccine effectiveness under real-world conditions, and understanding of barriers to uptake, are necessary to inform vaccine rollout.

METHODS: We enrolled cases (testing positive) and controls (testing negative) from among the population whose SARS-CoV-2 molecular diagnostic test results from 24 February-29 April 2021 were reported to the California Department of Public Health. Participants were matched on age, sex, and geographic region. We assessed participants’ self-reported history of mRNA-based COVID-19 vaccine receipt (BNT162b2 and mRNA-1273). Participants were considered fully vaccinated two weeks after second dose receipt. Among unvaccinated participants, we assessed willingness to receive vaccination. We measured vaccine effectiveness (VE) via the matched odds ratio of prior vaccination, comparing cases with controls.

RESULTS: We enrolled 1023 eligible participants aged ≥18 years. Among 525 cases, 71 (13.5%) received BNT162b2 or mRNA-1273; 20 (3.8%) were fully vaccinated with either product. Among 498 controls, 185 (37.1%) received BNT162b2 or mRNA-1273; 86 (16.3%) were fully vaccinated with either product. Two weeks after second dose receipt, VE was 87.0% (95% confidence interval: 68.6-94.6%) and 86.2% (68.4-93.9%) for BNT162b2 and mRNA-1273, respectively. Fully vaccinated participants receiving either product experienced 91.3% (79.3-96.3%) and 68.3% (27.9-85.7%) VE against symptomatic and asymptomatic infection, respectively. Among unvaccinated participants, 42.4% (159/375) residing in rural regions and 23.8% (67/281) residing in urban regions reported hesitancy to receive COVID-19 vaccination.

CONCLUSIONS: Authorized mRNA-based vaccines are effective at reducing documented SARS-CoV-2 infections within the general population of California. Vaccine hesitancy presents a barrier to reaching coverage levels needed for herd immunity.

PMID:34282839 | DOI:10.1093/cid/ciab640

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Meta-Analysis of Microdissected Breast Tumors Reveals Genes Regulated in the Stroma but Hidden in Bulk Analysis

Cancers (Basel). 2021 Jul 5;13(13):3371. doi: 10.3390/cancers13133371.

ABSTRACT

Transcriptome data provide a valuable resource for the study of cancer molecular mechanisms, but technical biases, sample heterogeneity, and small sample sizes result in poorly reproducible lists of regulated genes. Additionally, the presence of multiple cellular components contributing to cancer development complicates the interpretation of bulk transcriptomic profiles. To address these issues, we collected 48 microarray datasets derived from laser capture microdissected stroma or epithelium in breast tumors and performed a meta-analysis identifying robust lists of differentially expressed genes. This was used to create a database with carefully harmonized metadata that we make freely available to the research community. As predicted, combining the results of multiple datasets improved statistical power. Moreover, the separate analysis of stroma and epithelium allowed the identification of genes with different contributions in each compartment, which would not be detected by bulk analysis due to their distinct regulation in the two compartments. Our method can be profitably used to help in the discovery of biomarkers and the identification of functionally relevant genes in both the stroma and the epithelium. This database was made to be readily accessible through a user-friendly web interface.

PMID:34282769 | DOI:10.3390/cancers13133371

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Combination of the G-8 Screening Tool and Hand-Grip Strength to Predict Long-Term Overall Survival in Non-Small Cell Lung Cancer Patients Undergoing Stereotactic Body Radiotherapy

Cancers (Basel). 2021 Jul 5;13(13):3363. doi: 10.3390/cancers13133363.

ABSTRACT

The Geriatric 8 (G-8) is a known predictor of overall survival (OS) in older cancer patients, but is mainly based on nutritional aspects. This study aimed to assess if the G-8 combined with a hand-grip strength test (HGST) in patients with NSCLC treated with stereotactic body radiotherapy can predict long-term OS better than the G-8 alone. A total of 46 SBRT-treated patients with NSCLC of stage T1-T2N0M0 were included. Patients were divided into three groups: fit (normal G-8 and HGST), vulnerable (abnormal G-8 or HGST), or frail (abnormal G-8 and HGST). Statistically significant differences were found in 4-year OS between the fit, vulnerable, and frail groups (70% vs. 46% vs. 25%, p = 0.04), as well as between the normal and abnormal G-8 groups (69% vs. 39%, p = 0.02). In a multivariable analysis of OS, being vulnerable with a hazard ratio (HR) of 2.03 or frail with an HR of 3.80 indicated poorer OS, but this did not reach statistical significance. This study suggests that there might be a benefit of adding a physical test to the G-8 for more precisely predicting overall survival in SBRT-treated patients with localized NSCLC. However, this should be confirmed in a larger study population.

PMID:34282772 | DOI:10.3390/cancers13133363

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Genomewide alteration of histone H3K4 methylation underlies genetic vulnerability to psychopathology

J Genet. 2021;100:44.

ABSTRACT

Dysregulated histone methylation has emerged as a recurring theme in multiple neuropsychiatric disorders. However, it is yet unclear whether the altered histone methylation is associated with aetiologic mechanisms or an outcome of disease manifestation. In this study, we examined the genomewide association studies datasets of three major psychiatric disorders, schizophrenia (SCZ), bipolar disorder (BIP), and major depression disorder (MDD), which represents a total of 231,783 cases and 425,444 controls, to clarify the relationship. Our gene-set enrichment analysis results identified statistically significant association of genes involved in three histone methylation biological processes with the three adult-onset psychiatric disorders, which is mainly driven by the histone H3K4 methylation pathway (GO: 0051568). Further analysis of histone H3K4 methylation pathway genes revealed a widespread role of the genes in brain function and disease; 29 (52%) and 41 genes (73.2%) were associated with at least one brain-related trait or brain disorder, respectively. Spatiotemporal gene expression analysis suggests that these pathway genes play a critical role during the prenatal period and are consistent regulators in the cerebral cortex throughout an individual’s life. AUTS2, DNMT1 and TET2 are genes of particular interest due to their pervasive role in various aspects of brain function. Our findings support a critical aetiologic role of H3K4 methylation genes shared across SCZ, BIP and MDD, providing new direction for the development of epigenetically-focussed drugs targeting common causal factors of these devastating disorders.

PMID:34282735

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The role of external genital lesions in HIV seroconversion among men participating in a multinational study

Sex Transm Dis. 2021 Jul 17. doi: 10.1097/OLQ.0000000000001516. Online ahead of print.

ABSTRACT

BACKGROUND: Studies in women have shown an increased risk of HIV acquisition with prior HPV infection; however, few studies have been conducted among men. Our objective was to assess whether HPV-related external genital lesions (EGLs) increase risk of HIV seroconversion among men.

METHODS: A total of 1379 HIV-negative men aged 18-70 years from the US, Mexico, and Brazil were followed for up to seven years and underwent clinical examination for EGLs and blood draws every six-months. HIV seroconversion was assessed in archived serum. Cox proportional hazards and marginal structural models assessed the association between EGL status and time to HIV seroconversion.

RESULTS: 29 participants HIV seroconverted during follow-up. Older age was associated with a lower hazard of HIV seroconversion. We found no significant difference in the risk of HIV seroconversion between men with and without EGLs (adjusted hazard ratio [HR] = 0.94, 95%CI 0.32-2.74). Stratified analyses focusing on men that have sex with men found no association between EGLs and HIV seroconversion risk (HR = 0.63, 95%CI 0.00-1.86).

CONCLUSION: EGLs were not associated with higher risk for HIV seroconversion in this multinational population, although statistical power was limited as there were few HIV seroconversions. Results may differ in populations at higher risk for HIV.

PMID:34282740 | DOI:10.1097/OLQ.0000000000001516

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Childhood type 1 diabetes mellitus and risk factor of interactions between dietary cow’s milk intake and HLA-DR3/DR4 genotype

J Biomol Struct Dyn. 2021 Jul 20:1-9. doi: 10.1080/07391102.2021.1953599. Online ahead of print.

ABSTRACT

Short-term breastfeeding and early exposure to dairy products into infant diets, may be critical factors for development of type 1 diabetes. In this study, we investigate whether cow’s milk proteins are risk factors for type 1 diabetes in genetically susceptible individuals (HLA DR3/DR4) by using statistical analysis and in silico approach. In order to verify the potential risk of the early introduction of cow’s milk, we conducted this study to validate the veracity of this hypothesis in our population. We included 121 subjects, 55 type 1 diabetics and 74 controls from the region of Tlemcen (Algeria). Thus, the in silico approach was performed to determine the molecular mimicry region between Bovine serum albumin and beta-lactoglobulin with self-Islet antigen 2 and glutamate decarboxylase 65 by determining their sequences and their 3D structures. The risk factors associated with type 1 diabetes in a genetically predisposed individual (HLA DR3/DR4) retained by the logistic model are: type 1 and type 2 diabetes inheritance, the early introduction of cow’s milk before 6 months and breastfeeding less than 9 months. Besides, the epitopes of cow’s milk proteins have the capacity to bind to predisposing HLA class II molecules (HLA DR3/DR4) and induce an immune reaction by the secretion of Interleukin 4 (Th2) and Interferon (Th1) which lead to the destruction of pancreatic beta cells. The early introduction of cow’s milk proteins in susceptible individuals is considered as risk factors for the pathogenesis of T1DM. The in silico approach confirm that BSA and BLG share sequence and structure homology with IA2 and GAD65.Communicated by Ramaswamy H. Sarma.

PMID:34282715 | DOI:10.1080/07391102.2021.1953599

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The low glutamate diet improves cognitive functioning in veterans with Gulf War Illness and resting-state EEG potentially predicts response

Nutr Neurosci. 2021 Jul 20:1-12. doi: 10.1080/1028415X.2021.1954292. Online ahead of print.

ABSTRACT

Objectives: Gulf War Illness (GWI) is a chronic, multi-symptom disorder with underlying central nervous system dysfunction and cognitive impairments. The objective of this study was to test the low glutamate diet as a novel treatment for cognitive dysfunction among those with GWI, and to explore if baseline resting-state electroencephalography (EEG) could predict cognitive outcomes.Methods: Cognitive functioning was assessed at baseline, after one-month on the diet, and across a two-week double-blind, placebo-controlled crossover challenge with monosodium glutamate (MSG) relative to placebo.Results: Significant improvements were seen after one-month on the diet in overall cognitive functioning, and in all other domains tested (FDR p < 0.05), except for memory. Challenge with MSG resulted in significant inter-individual response variability (p < 0.0001). Participants were clustered according to baseline resting-state EEG using k-means clustering to explore the inter-individual response variability. Three distinct EEG clusters were observed, and each corresponded with differential cognitive effects during challenge with MSG: cluster 1 had cognitive benefit (24% of participants), cluster 2 had cognitive detriment (42% of participants), and cluster 3 had mild/mixed effects (33% of participants).Discussion: These findings suggest that the low glutamate diet may be a beneficial treatment for cognitive impairment in GWI. Future research is needed to understand the extent to which resting-state EEG can predict response to the low glutamate diet and to explore the mechanisms behind the varied response to acute glutamate challenge.

PMID:34282720 | DOI:10.1080/1028415X.2021.1954292

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Crucial Points in Phases of Totally Extraperitoneal (TEP) Hernia Repair. Learning Curve Analysis

Ann Ital Chir. 2021 Jun 21;10:S0003469X21036071. Online ahead of print.

ABSTRACT

AIM: Totally extra-peritoneal (TEP) repair technique is one of the most used laparoscopic techniques for inguinal hernia repair. This study aimed to investigate the learning curve of technique and phases involved to help guiding novice learners.

MATERIALS AND METHODS: Box-Jenkinson method for time series analysis and moving average method for standard deviation (SD) analysis and were employed for group determination and learning curve evaluation. Three individual groups were created based on the statistical analysis results and each group has been evaluated to determine the accuracy of the learning phases.

RESULTS: The learning phases of the technique were classified as: (1) Phase 1 (1st-28th case), (2) Phase 2 (29th-98th case), and Phase 3 (after 99th case). Operation time was statistically different between each phase. In addition, the number of intra-operative incidents was also found to be statistically different between phase-1 and other phases, with phase-1 being unfavorable.

CONCLUSION: To our knowledge, this is the first study that describes phases of learning the TEP hernia repair and compares these phases in terms of complication and operative time. We recommend that novice surgeons take extra care in terms of the selection of their patients during their first 28 cases and broaden their patient spectrum after the 63rd case. The learning curve of the TEP technique has three phases and each step must be carefully considered for patient selection so that milestones can be achieved as smoothly as possible without any complications.

KEY WORDS: Hernia, Laparoscopy, Learning curve, Moving average, TEP.

PMID:34282729

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Effects of exercise on depressive symptoms among nursing home residents: a meta-analysis

Aging Ment Health. 2021 Jul 20:1-10. doi: 10.1080/13607863.2021.1951658. Online ahead of print.

ABSTRACT

OBJECTIVE: We examined the effects of exercise on depression in older adults living in nursing homes and explored the moderator effects of participants, methods, and intervention characteristics.

METHODS: We searched 8 databases from inception to January 2020 without date restrictions. We retrieved primary studies measuring exercise with 60-year-olds with depression that were written in English. Two researchers independently coded each primary study and compared codes for discrepancies. They consulted a third researcher to come to consensus. We used random-effects model to compute effect sizes using Hedges’ g, a forest plot, and Q and I2 statistics as measures of heterogeneity. We also examined moderator analyses.

RESULTS: Twenty-one studies included 2,594 participants (81.8 ± 4.8 years old). Overall, exercise showed a small improvement in depression compared to controls (ES=.25; 95%CI 0.11, 0.38; p=.000). Interestingly, interventionists by physiotherapists had a smaller effect on depressive symptoms (.04) than other health interventionists (.37). As people aged, exercise was less effective in reducing depression (slope=-.03, Qmodel=5.03, p=.025). Researchers who included a higher percentage of women in exercise showed less improvement of depression (slope=-.01, Qmodel=8.60, p=.003). Also, when researchers used depression scales with higher reliability values, they measured higher levels of depression (slope = 5.48, Qmodel=5.60, p=.018). No other quality indicators moderated the effects of exercise on depression.

CONCLUSION: Exercise significantly improved depressive symptoms among older adults in nursing homes. Exercise might be used as adjunct/alternative complementary treatment for improving depressive symptoms in older adults in nursing homes.

PMID:34282683 | DOI:10.1080/13607863.2021.1951658