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Journal of Global Health Jun 2024Considering the large population of bronchiectasis and chronic obstructive pulmonary disease (COPD) patients in China, we aimed to conduct a thorough analysis that...
Analysis of clinical characteristics, prognosis and influencing factors in patients with bronchiectasis-chronic obstructive pulmonary disease overlap syndrome: A prospective study for more than five years.
BACKGROUND
Considering the large population of bronchiectasis and chronic obstructive pulmonary disease (COPD) patients in China, we aimed to conduct a thorough analysis that investigates the clinical characteristics and prognosis of bronchiectasis-COPD overlap syndrome (BCOS). Further, we aimed to explore factors associated with acute exacerbation and death in BCOS, which may be of value in its early diagnosis and intervention.
METHODS
We recruited inpatients with COPD from the second Xiangya Hospital of Central South University in China in August 2016, with follow-up until March 2022. Patients in the BCOS group had to meet the criteria for diagnosing bronchiectasis. We used self-completion questionnaires, clinical records, and self-reported data as primary data collection methods. We used Kaplan-Meier survival analyses and Cox proportional hazard models to assess the risk of severe acute exacerbation and death for BCOS during the follow-up period.
RESULTS
A total of 875 patients were included and followed up. Patients in the BCOS group had more females, fewer smokers, lower discharge COPD assessment test (CAT) scores, lower forced vital capacity (FVC), a higher likelihood of co-occurring active tuberculosis, higher levels of eosinophils and inflammatory markers, and a higher rate of positive sputum cultures for Pseudomonas aeruginosa than patients in the COPD-only group. Patients in the acute exacerbation group (AE+) were found to have lower body mass index (BMI), more frequent acute exacerbations, higher modified Medical Research Council (mMRC) dyspnoea grade on admission, higher inflammatory markers, lower FVC, higher rates of using inhaled bronchodilators, and higher rates of both positive and Pseudomonas aeruginosa positive sputum cultures. Patients in the 'death' group were older, had a lower BMI, had spent longer time in the hospital, had higher mMRC dyspnoea grade and CAT scores upon admission and discharge, had higher levels of inflammatory markers, lower rates of using inhaled bronchodilators, were more likely to have a combination of pulmonary heart disease and obsolete pulmonary tuberculosis, as well as a higher rate of fungus-positive sputum cultures. Both erythrocyte sedimentation rate at baseline and Pseudomonas aeruginosa culture positivity were confirmed as independent predictors of severe acute exacerbation in multivariate analysis during the years of follow-up. Fungus culture positivity baseline blood urea nitrogen, baseline lymphocyte count, comorbidities with obsolete pulmonary tuberculosis and comorbidities with pulmonary heart disease were verified as independent predictors of death in multivariate analysis during the years of follow-up. Kaplan-Meier curves under survival analysis demonstrated no statistically significant difference in mortality between the COPD and the BCOS groups at the full one, two, and three years of follow-up.
CONCLUSIONS
Patients with BCOS present with reduced lung function, increased susceptibility to different complications, elevated blood eosinophils and inflammatory markers, and elevated rates of positive Pseudomonas aeruginosa cultures. These distinctive markers are linked to a greater risk of severe acute exacerbations and mortality.
Topics: Humans; Female; Pulmonary Disease, Chronic Obstructive; Male; Bronchiectasis; Middle Aged; Prospective Studies; Aged; Prognosis; China; Risk Factors; Syndrome; Disease Progression
PubMed: 38940273
DOI: 10.7189/jogh.14.04129 -
Bioinformatics (Oxford, England) Jun 2024World Health Organization estimates that there were over 10 million cases of tuberculosis (TB) worldwide in 2019, resulting in over 1.4 million deaths, with a worrisome...
MOTIVATION
World Health Organization estimates that there were over 10 million cases of tuberculosis (TB) worldwide in 2019, resulting in over 1.4 million deaths, with a worrisome increasing trend yearly. The disease is caused by Mycobacterium tuberculosis (MTB) through airborne transmission. Treatment of TB is estimated to be 85% successful, however, this drops to 57% if MTB exhibits multiple antimicrobial resistance (AMR), for which fewer treatment options are available.
RESULTS
We develop a robust machine-learning classifier using both linear and nonlinear models (i.e. LASSO logistic regression (LR) and random forests (RF)) to predict the phenotypic resistance of Mycobacterium tuberculosis (MTB) for a broad range of antibiotic drugs. We use data from the CRyPTIC consortium to train our classifier, which consists of whole genome sequencing and antibiotic susceptibility testing (AST) phenotypic data for 13 different antibiotics. To train our model, we assemble the sequence data into genomic contigs, identify all unique 31-mers in the set of contigs, and build a feature matrix M, where M[i, j] is equal to the number of times the ith 31-mer occurs in the jth genome. Due to the size of this feature matrix (over 350 million unique 31-mers), we build and use a sparse matrix representation. Our method, which we refer to as MTB++, leverages compact data structures and iterative methods to allow for the screening of all the 31-mers in the development of both LASSO LR and RF. MTB++ is able to achieve high discrimination (F-1 >80%) for the first-line antibiotics. Moreover, MTB++ had the highest F-1 score in all but three classes and was the most comprehensive since it had an F-1 score >75% in all but four (rare) antibiotic drugs. We use our feature selection to contextualize the 31-mers that are used for the prediction of phenotypic resistance, leading to some insights about sequence similarity to genes in MEGARes. Lastly, we give an estimate of the amount of data that is needed in order to provide accurate predictions.
AVAILABILITY
The models and source code are publicly available on Github at https://github.com/M-Serajian/MTB-Pipeline.
Topics: Mycobacterium tuberculosis; Machine Learning; Drug Resistance, Bacterial; Microbial Sensitivity Tests; Anti-Bacterial Agents; Whole Genome Sequencing; Genome, Bacterial; Humans
PubMed: 38940175
DOI: 10.1093/bioinformatics/btae243 -
Frontiers in Bioscience (Landmark... May 2024Epigenetics refers to heritable changes in gene expression and function that impact nuclear processes associated with chromatin, all without altering DNA sequences.... (Review)
Review
Epigenetics refers to heritable changes in gene expression and function that impact nuclear processes associated with chromatin, all without altering DNA sequences. These epigenetic patterns, being heritable traits, are vital biological mechanisms that intricately regulate gene expression and heredity. The application of chemical labeling and single-cell resolution mapping strategies has significantly facilitated large-scale epigenetic modifications in nucleic acids over recent years. Notably, epigenetic modifications can induce heritable phenotypic changes, regulate cell differentiation, influence cell-specific gene expression, parentally imprint genes, activate the X chromosome, and stabilize genome structure. Given their reversibility and susceptibility to environmental factors, epigenetic modifications have gained prominence in disease diagnosis, significantly impacting clinical medicine research. Recent studies have uncovered strong links between epigenetic modifications and the pathogenesis of metabolic cardiovascular diseases, including congenital heart disease, heart failure, cardiomyopathy, hypertension, and atherosclerosis. In this review, we provide an overview of the progress in epigenetic research within the context of cardiovascular diseases, encompassing their pathogenesis, prevention, diagnosis, and treatment. Furthermore, we shed light on the potential prospects of nucleic acid epigenetic modifications as a promising avenue in clinical medicine and biomedical applications.
Topics: Humans; Epigenesis, Genetic; Cardiovascular Diseases; DNA Methylation; Animals
PubMed: 38940023
DOI: 10.31083/j.fbl2906205 -
Annals of Ibadan Postgraduate Medicine Apr 2024Since the resurgence of mpox disease in 2017, Nigeria alone has accounted for about 60% of confirmed cases reported in the African region. This study therefore aimed to...
BACKGROUND
Since the resurgence of mpox disease in 2017, Nigeria alone has accounted for about 60% of confirmed cases reported in the African region. This study therefore aimed to understand the knowledge and perception of the general public towards the mpox infection.
METHODS
We conducted a cross-sectional study among 958 community members across three states (Oyo, Lagos and Jigawa) in Nigeria. Knowledge of mpox infection was assessed across four domains: (1) general knowledge, (2) transmission, (3) signs and symptoms, and (4) prevention and treatment where we assigned a score of 1 for each correct response. Binary logistic regression was conducted to explore factors associated with knowledge of mpox infection at 5% level of significance. We assessed perception of mpox infection across 5 constructs (perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and self-efficacy) from the health belief model, using 3-point Likert scales. We used Kruskal-Wallis and Mann-Whitney- U tests to assess factors associated with each construct.
RESULTS
Overall, only about one-third (38.3%) of community members were aware of mpox infection. There were variations in perceptions and knowledge across the three states. Knowledge of mpox infection transmission, prevention, and treatment was low across the states. Only 28.9% of respondents knew that sharing utensils with an infected person is a means of contracting the disease, and just 15.9% were aware that mpox infection may resolve spontaneously. The mean of general knowledge scores was higher in Jigawa 14.8 (±3.2) compared to Lagos 12.1 (±4.1) and Oyo states 12.5 (±5.6) (p<0.001).Respondents with tertiary-level education (p=0.001) were significantly more likely to perceive themselves as susceptible to mpox while males (p<0.001) and respondents who live in Jigawa state (p=0.002) were significantly more likely to perceive mpox as severe with 90.5% believing that being infected will stop their daily activity (p<0.001). Perceived barriers to adherence to mpox preventive strategies were higher in Jigawa state (p<0.001), with 68.3% reporting that use of hand sanitizers might be expensive for them.
CONCLUSION
The analysis of our findings revealed significant knowledge gaps and a very low level of public awareness about mpox. Key areas of limited knowledge included the disease's route of transmission, as well as its prevention and treatment. To control the spread of mpox infection, there is need to strengthen public health risk communication focusing on the transmission and preventive actions.
PubMed: 38939883
DOI: No ID Found -
Plant Phenomics (Washington, D.C.) 2024Grape cluster architecture and compactness are complex traits influencing disease susceptibility, fruit quality, and yield. Evaluation methods for these traits include...
Grape cluster architecture and compactness are complex traits influencing disease susceptibility, fruit quality, and yield. Evaluation methods for these traits include visual scoring, manual methodologies, and computer vision, with the latter being the most scalable approach. Most of the existing computer vision approaches for processing cluster images often rely on conventional segmentation or machine learning with extensive training and limited generalization. The Segment Anything Model (SAM), a novel foundation model trained on a massive image dataset, enables automated object segmentation without additional training. This study demonstrates out-of-the-box SAM's high accuracy in identifying individual berries in 2-dimensional (2D) cluster images. Using this model, we managed to segment approximately 3,500 cluster images, generating over 150,000 berry masks, each linked with spatial coordinates within their clusters. The correlation between human-identified berries and SAM predictions was very strong (Pearson's = 0.96). Although the visible berry count in images typically underestimates the actual cluster berry count due to visibility issues, we demonstrated that this discrepancy could be adjusted using a linear regression model (adjusted = 0.87). We emphasized the critical importance of the angle at which the cluster is imaged, noting its substantial effect on berry counts and architecture. We proposed different approaches in which berry location information facilitated the calculation of complex features related to cluster architecture and compactness. Finally, we discussed SAM's potential integration into currently available pipelines for image generation and processing in vineyard conditions.
PubMed: 38939746
DOI: 10.34133/plantphenomics.0202 -
Frontiers in Public Health 2024Ticks and pathogens they carry seriously impact human and animal health, with some diseases like Lyme and Alpha-gal syndrome posing risks. Searching for health...
INTRODUCTION
Ticks and pathogens they carry seriously impact human and animal health, with some diseases like Lyme and Alpha-gal syndrome posing risks. Searching for health information online can change people's health and preventive behaviors, allowing them to face the tick risks. This study aimed to predict the potential risks of tickborne diseases by examining individuals' online search behavior.
METHODS
By scrutinizing the search trends across various geographical areas and timeframes within the United States, we determined outdoor activities associated with potential risks of tick-related diseases. Google Trends was used as the data collection and analysis tool due to its accessibility to big data on people's online searching behaviors. We interact with vast amounts of population search data and provide inferences between population behavior and health-related phenomena. Data were collected in the United States from April 2022 to March 2023, with some terms about outdoor activities and tick risks.
RESULTS AND DISCUSSION
Results highlighted the public's risk susceptibility and severity when participating in activities. Our results found that searches for terms related to tick risk were associated with the five-year average Lyme Disease incidence rates by state, reflecting the predictability of online health searching for tickborne disease risks. Geographically, the results revealed that the states with the highest relative search volumes for tick-related terms were predominantly located in the Eastern region. Periodically, terms can be found to have higher search records during summer. In addition, the results showed that terms related to outdoor activities, such as "corn maze," "hunting," "u-pick," and "park," have moderate associations with tick-related terms. This study provided recommendations for effective communication strategies to encourage the public's adoption of health-promoting behaviors. Displaying warnings in the online search results of individuals who are at high risk for tick exposure or collaborating with outdoor activity locations to disseminate physical preventive messages may help mitigate the risks associated with tickborne diseases.
Topics: Humans; Tick-Borne Diseases; United States; Animals; Search Engine; Internet; Lyme Disease; Ticks; Information Seeking Behavior
PubMed: 38939559
DOI: 10.3389/fpubh.2024.1410713 -
Health Care Science Aug 2023Mental health conditions are known to increase susceptibility to infectious diseases, including coronavirus disease 2019 (COVID-19). Health behaviors play a crucial role...
BACKGROUND
Mental health conditions are known to increase susceptibility to infectious diseases, including coronavirus disease 2019 (COVID-19). Health behaviors play a crucial role in mitigating this susceptibility. We aim to examine the differential effectiveness of COVID-19 preventive health behaviors among individuals, considering the presence or absence of specific mental health disorders.
METHODS
Multivariable logistic regression with interaction terms was performed to examine whether associations between adherence to health behaviors and COVID-19 infection were conditional on depression, anxiety, or eating disorders in a national sample of adults ( = 61,891) from 140 US universities, 2020-2021.
RESULTS
Adjusting for age, race/ethnicity, and gender/sex, the effectiveness of mask-wearing was significant and comparable among individuals with and without depression, anxiety, or eating disorders. Social distancing provided significantly less protection among individuals with depression, anxiety, or eating disorders. Hygiene practice provided significantly less protection among individuals with anxiety.
CONCLUSION
Mask-wearing is robustly effective in the prevention of COVID-19 among individuals. However, social distancing and hygiene practice provide less significant protection among individuals with certain mental health conditions, suggesting the importance of prioritizing these individuals for additional preventive measures (e.g., vaccines targeting variants) and mitigation strategies (e.g., financial assistance, targeted mental health care, health education).
PubMed: 38939519
DOI: 10.1002/hcs2.60 -
Acta Medica Philippina 2024Based on the 2017-2020 annual report of the Department of Health-Antimicrobial Resistance Surveillance Program, significant resistance patterns have been observed for...
BACKGROUND
Based on the 2017-2020 annual report of the Department of Health-Antimicrobial Resistance Surveillance Program, significant resistance patterns have been observed for common disease-causing pathogens. In the hospital setting, antimicrobial stewardship programs have been implemented to optimize the use of antimicrobials. Drug utilization review studies provide essential feedback to improve prescribing and use of medications.
OBJECTIVES
This study aimed to review drug utilization of monitored parenteral antimicrobials among patients admitted from January to December 2019.
METHODS
The study employed a retrospective, cross-sectional, descriptive research design. A retrospective chart review of drugs administered to patients was conducted.
RESULTS
A total of 821 patients charts met the inclusion criteria. The patients' ages ranged from 18 to 98 years old and 52% were females. General Internal Medicine practitioners (28%) were the top prescribers of monitored parenteral antimicrobials primarily for the management of moderate-risk community-acquired pneumonia (39%). They were mostly indicated for empirical treatment of infections (94%) and were given for an average of 5.73 days.Only 58% of the total cases had orders for culture and sensitivity testing. Of which, principally 47% had colony cultures. Blood (29%) and sputum (27%) were the most common specimens taken for culture and sensitivity testing. The microorganisms often isolated were (19%), (18%), and (9%). In addition, extended-spectrum beta lactamase-producing gram-negative pathogens (4%) and methicillin-resistant (1%) were also isolated. All the microorganisms isolated showed most resistance to ampicillin (81%) and most susceptibility to colistin (100%). There were drug therapy-related problems encountered. There was one case of an adverse drug reaction (0.1%) and two cases of contraindications (0.2%). Therapeutic duplication was also observed in 5% of the cases. Moreover, 39% had instances of drug-drug interactions.Piperacillin-tazobactam had the highest consumption (79.50 defined daily doses/1,000-patient days) among the monitored parenteral antimicrobials.Some prescriptions were deemed inappropriate upon evaluation. 12% of cases were inappropriate based on the justification indicator. As for the critical indicators, duration of therapy (78%) was the main reason. Only four components of the DUE criteria indicators have met or exceeded the established threshold level.The cost analysis indicated that the total actual cost of therapy with the monitored parenteral antimicrobials amounted to ₱17,645,601.73. Considering Department of Health National Antibiotic Guidelines recommendations, ideal total cost of treatment was ₱14,917,214.29. Potential cumulative cost savings of ₱2,728,387.44 could have been achieved for patients admitted last 2019.
CONCLUSION
Consumption of piperacillin-tazobactam was relatively high as compared to the other monitored parenteral antimicrobials covered in this study. Physicians at the study site seldom prescribe monitored parenteral antimicrobials as recommended by the National Antibiotic Guidelines. This is evidenced in the incidence of inappropriate therapy regimens, with inapt duration of therapy as the leading explanation.From the patient's perspective, the main economic implication was on the direct medical costs, particularly the increased cost of the actual antimicrobial therapy prescribed to manage various infections. Adherence of physicians to the established guidelines and selection of the most cost-effective therapy could have resulted in considerable cost savings.
PubMed: 38939423
DOI: 10.47895/amp.vi0.7249 -
Cureus May 2024The Achilles tendon is vital for walking and running, but it's also the most frequently ruptured tendon. Ruptures often occur without direct trauma and present with...
The Achilles tendon is vital for walking and running, but it's also the most frequently ruptured tendon. Ruptures often occur without direct trauma and present with acute posterior ankle/heel pain. Various factors like age, biomechanical properties, degeneration, and mechanical factors influence susceptibility to rupture. Mechanisms of injury vary, including weight-bearing forefoot pushing off and sudden dorsiflexion of the ankle. Management goals focus on minimizing morbidity, swift recovery, and preventing complications through tailored interventions. Systemic lupus erythematosus (SLE) can also contribute to tendon rupture, especially with prolonged corticosteroid use. A 32-year-old female presented to the ER after injuring her left foot during a basketball game. She was diagnosed with an Achilles tendon rupture and underwent surgery to repair it. However, she experienced delayed wound closure and needed a skin graft. Two months later, she suffered another rupture in a different location, requiring a tendon transfer surgery. She was finally diagnosed with SLE after tests by the Rheumatology Department. Treatment commenced, and she began rehabilitation four weeks post-surgery. Surgical management of ruptured Achilles tendon involves techniques like open repair, percutaneous repair, mini-open repair, and augmentative repair. Open repair involves a direct approach with a posteromedial incision to align tendon stumps using various stitching techniques. Conservative treatment involves immobilization and non-weight-bearing for at least four weeks post surgery. For rare cases of Achilles tendon rupture caused by lupus, treatment focuses on managing the underlying disease with medications like hydroxychloroquine and glucocorticosteroids. Comprehensive evaluation, including musculoskeletal assessment, is crucial for lupus patients. SLE needs to be considered as a potential cause, especially in cases of recurrent ruptures or additional musculoskeletal symptoms. Surgical management should be tailored to individual patient needs, while also considering surgeon proficiency and preferences.
PubMed: 38939241
DOI: 10.7759/cureus.61231 -
JACC. Advances Jun 2024Abdominal aortic aneurysm (AAA) is an important cause of cardiovascular mortality.
BACKGROUND
Abdominal aortic aneurysm (AAA) is an important cause of cardiovascular mortality.
OBJECTIVES
The authors aimed to explore the associations between sleep patterns and genetic susceptibility to AAA.
METHODS
We included 344,855 UK Biobank study participants free of AAA at baseline. A sleep pattern was defined by chronotype, sleep duration, insomnia, snoring, and daytime sleepiness, and an overall sleep score was constructed with a range from 0 to 5, where a high score denotes a healthy sleep pattern. Polygenic risk score based on 22 single nucleotide polymorphisms was categorized into tertiles and used to evaluate the genetic risk for AAA. Cox proportional hazards regression models were used to assess the association between sleep, genetic factors, and the incidence of AAA.
RESULTS
During a median of 12.59 years of follow-up, 1,622 incident AAA cases were identified. The HR per 1-point increase in the sleep score was 0.91 (95% CI: 0.86-0.96) for AAA. Unhealthy sleep patterns, defined as a sleep score ranging from 0 to 3, were found to be associated with a higher risk of AAA for the intermediate (HR: 1.18, 95% CI: 1.06-1.31) and poor sleep patterns (HR: 1.40, 95% CI: 1.13-1.73), respectively, compared to the healthy pattern. Participants with poor sleep patterns and high genetic risks had a 2.5-fold higher risk of AAA than those with healthy sleep patterns and low genetic risk.
CONCLUSIONS
In this large prospective study, healthy sleep patterns were associated with a lower risk of AAA among participants with low, intermediate, or high genetic risk.
PubMed: 38938869
DOI: 10.1016/j.jacadv.2024.100967