-
Frontiers in Endocrinology 2024The existing research on the association between apolipoproteins (Apos) and erectile dysfunction (ED) primarily relies on observational studies and does not distinguish...
The existing research on the association between apolipoproteins (Apos) and erectile dysfunction (ED) primarily relies on observational studies and does not distinguish between organic and psychogenic causes when diagnosing ED. It is difficult to believe that Apos play a role in psychogenic ED. To address these issues, our study explored the causal relationship between lipoproteins and ED using Mendelian randomization (MR) analysis and differentiate between organic and psychogenic ED through the use of nocturnal penile tumescence and rigidity (NPTR) monitoring. Multivariate MR analysis revealed significant causal associations between high-density lipoprotein (HDL), Apo A1, and Apo B/A1 with ED (OR and 95% CI were 0.33 (0.14-0.78), 3.58 (1.52-8.43), and 0.30 (0.13-0.66)). we conducted statistical and analytical analyses on the data of 212 patients using multivariate analyses and receiver operating characteristic (ROC) curves. Patients with organic ED had significantly lower levels of HDL, Apo A1 and Apo A1/B, whereas patients with organic ED had considerably higher levels of Apo B and low-density lipoprotein (LDL). The diagnostic value of Apos in predicting the risk of organic ED was evaluated using ROC curves. The results indicated that Apo A1 and Apo A1/B demonstrated good predictive value. HDL, Apo A1, and Apo A1/B have been identified as risk factors for ED in our study. Furthermore, our research highlights the significance of Apo A1 and Apo A1/Apo B in the development of organic ED and suggests their potential use as indicators to assess the risks associated with organic ED.
Topics: Humans; Male; Mendelian Randomization Analysis; Erectile Dysfunction; Case-Control Studies; Middle Aged; Apolipoproteins; Adult; Apolipoprotein A-I; Lipoproteins, HDL
PubMed: 38938512
DOI: 10.3389/fendo.2024.1359015 -
Frontiers in Pediatrics 2024Congenital Heart Disease (CHD) is the most common congenital disorder and a leading cause of infant mortality. Despite improved survival rates, patients with CHD often...
INTRODUCTION
Congenital Heart Disease (CHD) is the most common congenital disorder and a leading cause of infant mortality. Despite improved survival rates, patients with CHD often face malnutrition due to increased metabolic demands, feeding difficulties, and gastrointestinal dysfunction. Malnutrition in CHD is linked to poor short and long-term clinical outcomes. Gastrostomy (GT) is frequently used for long-term enteral support, and laparoscopic GT (LGT) has demonstrated advantages in children without CHD. This study evaluated a modified Georgeson's percutaneous LGT technique and its perioperative complications in children with CHD.
METHODS
We performed an analytical retrospective cohort study from 2018 to 2022, including patients younger than 24 months with a diagnosis of CHD who underwent LGT. The primary outcome evaluated was the presence of complications during surgery and the first thirty postoperative days. Complications were graded using Clavien-Dindo's (CD) classification. Sociodemographic, clinical, and procedure-related variables were collected. A bivariate analysis was performed using STATA 15, and a < 0.05 was considered statistically significant.
RESULTS
Seventy-eight patients were eligible (male 56.41%, Median age 129.5 days, weight: 4.83 kg). The median surgery time was 35 min. The complication rate was 24.36%. The most frequent complications were GT site infection (10.26%), followed by leakage (8.97%) and granuloma formation (6.41%). Conversion to open surgery was significantly associated with postoperative complications ( = 0.002).
CONCLUSION
This modified technique is well-tolerated in children with CHD, demonstrating a low rate of CD grade 3A/3B complications and no grade 4 or 5 complications.
PubMed: 38938503
DOI: 10.3389/fped.2024.1405793 -
Frontiers in Artificial Intelligence 2024The health inequalities experienced by ethnic minorities have been a persistent and global phenomenon. The diagnosis of different types of skin conditions, e.g.,... (Review)
Review
Technology innovation to reduce health inequality in skin diagnosis and to improve patient outcomes for people of color: a thematic literature review and future research agenda.
The health inequalities experienced by ethnic minorities have been a persistent and global phenomenon. The diagnosis of different types of skin conditions, e.g., melanoma, among people of color is one of such health domains where misdiagnosis can take place, potentially leading to life-threatening consequences. Although Caucasians are more likely to be diagnosed with melanoma, African Americans are four times more likely to present stage IV melanoma due to delayed diagnosis. It is essential to recognize that additional factors such as socioeconomic status and limited access to healthcare services can be contributing factors. African Americans are also 1.5 times more likely to die from melanoma than Caucasians, with 5-year survival rates for African Americans significantly lower than for Caucasians (72.2% vs. 89.6%). This is a complex problem compounded by several factors: ill-prepared medical practitioners, lack of awareness of melanoma and other skin conditions among people of colour, lack of information and medical resources for practitioners' continuous development, under-representation of people of colour in research, POC being a notoriously hard to reach group, and 'whitewashed' medical school curricula. Whilst digital technology can bring new hope for the reduction of health inequality, the deployment of artificial intelligence in healthcare carries risks that may amplify the health disparities experienced by people of color, whilst digital technology may provide a false sense of participation. For instance, Derm Assist, a skin diagnosis phone application which is under development, has already been criticized for relying on data from a limited number of people of color. This paper focuses on understanding the problem of misdiagnosing skin conditions in people of color and exploring the progress and innovations that have been experimented with, to pave the way to the possible application of big data analytics, artificial intelligence, and user-centred technology to reduce health inequalities among people of color.
PubMed: 38938325
DOI: 10.3389/frai.2024.1394386 -
Journal of Preventive Medicine and... Jun 2024Chronic anaemia is a significant health concern, particularly among women of childbearing age. Factors such as menstrual blood loss, childbirth, inadequate nutrition,...
OBJECTIVES
Chronic anaemia is a significant health concern, particularly among women of childbearing age. Factors such as menstrual blood loss, childbirth, inadequate nutrition, closely spaced pregnancies, and recurrent gastrointestinal bleeding increase the risk of anaemia. This study investigated whether current contraceptive methods are associated with anaemia in Indian women of reproductive age.
METHODS
Cross-sectional data from the fifth round of the National Family Health Survey, conducted in 2019-21, were used for this investigation (NFHS-5). We included only non-pregnant and non-amenorrhoeic women in our analysis, resulting in a final analytical sample of 673,094 women aged 15-49. Bivariate cross-tabulations and multivariable logistic regression were employed to analyse the data.
RESULTS
The prevalence of anaemia was 57%, and the adjusted regression models found no significant association between the use of any contraceptive methods and women's haemoglobin status. Women using traditional contraceptive methods had 1.08 (95% confidence interval, 1.048-1.113) times higher odds of having anaemia. Among the modern methods, other than injectables, all other methods-such as an intrauterine device (IUD), barrier use, and sterilisation-were associated with higher odds of anaemia compared to women who used contraceptive pills.
CONCLUSIONS
This study explored the relationship between modern contraceptives and haemoglobin levels in India, revealing that injectables were associated with a notable reduction in the odds of anaemia, whereas traditional contraceptives and other modern methods exhibited positive associations with anaemia. These findings prompt policymakers to focus on anaemia reduction and safe contraceptives. More research is needed to inform decisions, given the scant literature.
PubMed: 38938050
DOI: 10.3961/jpmph.23.504 -
Parasites & Vectors Jun 2024Digital imaging combined with deep-learning-based computational image analysis is a growing area in medical diagnostics, including parasitology, where a number of...
BACKGROUND
Digital imaging combined with deep-learning-based computational image analysis is a growing area in medical diagnostics, including parasitology, where a number of automated analytical devices have been developed and are available for use in clinical practice.
METHODS
The performance of Parasight All-in-One (AIO), a second-generation device, was evaluated by comparing it to a well-accepted research method (mini-FLOTAC) and to another commercially available test (Imagyst). Fifty-nine canine and feline infected fecal specimens were quantitatively analyzed by all three methods. Since some samples were positive for more than one parasite, the dataset consisted of 48 specimens positive for Ancylostoma spp., 13 for Toxocara spp. and 23 for Trichuris spp.
RESULTS
The magnitude of Parasight AIO counts correlated well with those of mini-FLOTAC but not with those of Imagyst. Parasight AIO counted approximately 3.5-fold more ova of Ancylostoma spp. and Trichuris spp. and 4.6-fold more ova of Toxocara spp. than the mini-FLOTAC, and counted 27.9-, 17.1- and 10.2-fold more of these same ova than Imagyst, respectively. These differences translated into differences between the test sensitivities at low egg count levels (< 50 eggs/g), with Parasight AIO > mini-FLOTAC > Imagyst. At higher egg counts Parasight AIO and mini-FLOTAC performed with comparable precision (which was significantly higher that than Imagyst), whereas at lower counts (> 30 eggs/g) Parasight was more precise than both mini-FLOTAC and Imagyst, while the latter two methods did not significantly differ from each other.
CONCLUSIONS
In general, Parasight AIO analyses were both more precise and sensitive than mini-FLOTAC and Imagyst and quantitatively correlated well with mini-FLOTAC. While Parasight AIO produced lower raw counts in eggs-per-gram than mini-FLOTAC, these could be corrected using the data generated from these correlations.
Topics: Animals; Cats; Dogs; Feces; Dog Diseases; Parasite Egg Count; Cat Diseases; Toxocara; Ancylostoma; Trichuris; Helminths; Helminthiasis, Animal; Ovum
PubMed: 38937854
DOI: 10.1186/s13071-024-06351-0 -
Human Genomics Jun 2024Wastewater surveillance (WWS) acts as a vigilant sentinel system for communities, analysing sewage to protect public health by detecting outbreaks and monitoring trends...
EU surveys insights: analytical tools, future directions, and the essential requirement for reference materials in wastewater monitoring of SARS-CoV-2, antimicrobial resistance and beyond.
BACKGROUND
Wastewater surveillance (WWS) acts as a vigilant sentinel system for communities, analysing sewage to protect public health by detecting outbreaks and monitoring trends in pathogens and contaminants. To achieve a thorough comprehension of present and upcoming practices and to identify challenges and opportunities for standardisation and improvement in WWS methodologies, two EU surveys were conducted targeting over 750 WWS laboratories across Europe and other regions. The first survey explored a diverse range of activities currently undertaken or planned by laboratories. The second survey specifically targeted methods and quality controls utilised for SARS-CoV-2 surveillance.
RESULTS
The findings of the two surveys provide a comprehensive insight into the procedures and methodologies applied in WWS. In Europe, WWS primarily focuses on SARS-CoV-2 with 99% of the survey participants dedicated to this virus. However, the responses highlighted a lack of standardisation in the methodologies employed for monitoring SARS-CoV-2. The surveillance of other pathogens, including antimicrobial resistance, is currently fragmented and conducted by only a limited number of laboratories. Notably, these activities are anticipated to expand in the future. Survey replies emphasise the collective recognition of the need to enhance the accuracy of results in WWS practices, reflecting a shared commitment to advancing precision and effectiveness in WWS methodologies.
CONCLUSIONS
These surveys identified a lack of standardised common procedures in WWS practices and the need for quality standards and reference materials to enhance the accuracy and reliability of WWS methods in the future. In addition, it is important to broaden surveillance efforts beyond SARS-CoV-2 to include other emerging pathogens and antimicrobial resistance to ensure a comprehensive approach to protecting public health.
Topics: Humans; Wastewater; SARS-CoV-2; COVID-19; Europe; Surveys and Questionnaires; Sewage; Drug Resistance, Microbial
PubMed: 38937848
DOI: 10.1186/s40246-024-00641-5 -
BMC Medical Informatics and Decision... Jun 2024The analysis of extensive electronic health records (EHR) datasets often calls for automated solutions, with machine learning (ML) techniques, including deep learning...
The analysis of extensive electronic health records (EHR) datasets often calls for automated solutions, with machine learning (ML) techniques, including deep learning (DL), taking a lead role. One common task involves categorizing EHR data into predefined groups. However, the vulnerability of EHRs to noise and errors stemming from data collection processes, as well as potential human labeling errors, poses a significant risk. This risk is particularly prominent during the training of DL models, where the possibility of overfitting to noisy labels can have serious repercussions in healthcare. Despite the well-documented existence of label noise in EHR data, few studies have tackled this challenge within the EHR domain. Our work addresses this gap by adapting computer vision (CV) algorithms to mitigate the impact of label noise in DL models trained on EHR data. Notably, it remains uncertain whether CV methods, when applied to the EHR domain, will prove effective, given the substantial divergence between the two domains. We present empirical evidence demonstrating that these methods, whether used individually or in combination, can substantially enhance model performance when applied to EHR data, especially in the presence of noisy/incorrect labels. We validate our methods and underscore their practical utility in real-world EHR data, specifically in the context of COVID-19 diagnosis. Our study highlights the effectiveness of CV methods in the EHR domain, making a valuable contribution to the advancement of healthcare analytics and research.
Topics: Electronic Health Records; Humans; Deep Learning; COVID-19; Machine Learning
PubMed: 38937744
DOI: 10.1186/s12911-024-02581-5 -
Scientific Reports Jun 2024Previous studies have reported associations between newly diagnosed diabetes and poor outcomes after percutaneous coronary intervention (PCI), but there is limited data...
Previous studies have reported associations between newly diagnosed diabetes and poor outcomes after percutaneous coronary intervention (PCI), but there is limited data focusing on elderly patients (age ≥ 65). This study aimed to analyze the prevalence and clinical implications of newly diagnosed diabetes in elderly patients who underwent PCI. From 2004 to 2021, a total of 2456 elderly patients who underwent invasive PCI at Korea University Guro Hospital were prospectively enrolled and followed up for a median of five years. The primary endpoint was five-year major adverse cardiovascular events (MACE). Cox regression was used to evaluate whether newly diagnosed diabetes impacted on long-term clinical outcomes. Newly diagnosed diabetes was presented in approximately 8.1% to 10.9% of elderly patients who underwent PCI. Those who had a new diagnosis of diabetes had a higher risk of MACE than previously known diabetes (25.28% vs. 19.15%, p = 0.039). After adjusting for significant factors, newly diagnosed diabetes remained an independent predictor of MACE (HR [hazard ratio] 1.64, 95% confidence interval [CI] 1.24-2.17, p < 0.001), cardiac death (HR 2.15, 95% CI 1.29-3.59, p = 0.003) and repeat revascularization (HR 1.52, 95% CI 1.09-2.11, p = 0.013), but not for non-fatal myocardial infarction (HR 1.66, 95% CI 0.94-2.12, p = 0.081). Newly diagnosed diabetes was associated with an increased risk of 5-year MACE compared with non-diabetes and previously diagnosed diabetes in elderly patients underwent PCI. More attention should be given to those elderly newly diagnosed diabetes population.
Topics: Humans; Percutaneous Coronary Intervention; Aged; Male; Female; Prevalence; Diabetes Mellitus; Risk Factors; Republic of Korea; Aged, 80 and over; Treatment Outcome; Prospective Studies; Proportional Hazards Models
PubMed: 38937534
DOI: 10.1038/s41598-024-65426-1 -
Scientific Reports Jun 2024Using a trustworthy electrochemical sensor in the detection of urea in real blood samples received a great attention these days. A thin layer of nickel-coated...
Using a trustworthy electrochemical sensor in the detection of urea in real blood samples received a great attention these days. A thin layer of nickel-coated nickel-manganese (Ni@NiMn) is electrodeposited on a glassy carbon electrode (GC) (Ni@NiMn/GC) surface and used to construct the electrochemical sensor for urea detection. Whereas, electrodeposition is considered as strong technique for the controllable synthesis of nanoparticles. Thus, X-ray diffraction (XRD), atomic force microscope (AFM), and scanning electron microscope (SEM) techniques were used to characterize the produced electrode. AFM and SEM pictures revealed additional details about the surface morphology, which revealed a homogenous and smooth coating. Furthermore, electrochemical research was carried out in alkaline medium utilizing various electrochemical methods, including cyclic voltammetry (CV), chronoamperometry (CA), and electrochemical impedance spectroscopy (EIS). The electrochemical investigations showed that the electrode had good performance, high stability and effective charge transfer capabilities. The structural, morphological, and electrochemical characteristics of Ni@NiMn/GC electrodes were well understood using the analytical and electrochemical techniques. The electrode showed a limit of detection (LOD) equal to 0.0187 µM and a linear range of detection of 1.0-10 mM of urea. Furthermore, real blood samples were used to examine the efficiency of the prepared sensor. Otherwise, the anti-interfering ability of the modified catalyst was examined toward various interfering species.
PubMed: 38937495
DOI: 10.1038/s41598-024-64707-z -
Scientific Reports Jun 2024Maternal mortality ratio (MMR) estimates have been studied over time for understanding its variation across the country. However, it is never sufficient without...
Maternal mortality ratio (MMR) estimates have been studied over time for understanding its variation across the country. However, it is never sufficient without accounting for presence of variability across in terms of space, time, maternal and system level factors. The study endeavours to estimate and quantify the effect of exposures encompassing all maternal health indicators and system level indicators along with space-time effects influencing MMR in India. Using the most recent level of possible -factors of MMR, maternal health indicators from the National Family Health Survey (NFHS: 2019-21) and system level indicators from government reports a heatmap compared the relative performance of all 19 SRS states. Facet plots with a regression line was utilised for studying patterns of MMR for different states in one frame. Using Bayesian Spatio-temporal random effects, evidence for different MMR patterns and quantification of spatial risks among individual states was produced using estimates of MMR from SRS reports (2014-2020). India has witnessed a decline in MMR, and for the majority of the states, this drop is linear. Few states exhibit cyclical trend such as increasing trends for Haryana and West Bengal which was evident from the two analytical models i.e., facet plots and Bayesian spatio- temporal model. Period of major transition in MMR levels which was common to all states is identified as 2009-2013. Bihar and Assam have estimated posterior probabilities for spatial risk that are relatively greater than other SRS states and are classified as hot spots. More than the individual level factors, health system factors account for a greater reduction in MMR. For more robust findings district level reliable estimates are required. As evident from our study the two most strong health system influencers for reducing MMR in India are Institutional delivery and Skilled birth attendance.
Topics: India; Humans; Female; Maternal Mortality; Bayes Theorem; Pregnancy; Adult; Maternal Health
PubMed: 38937489
DOI: 10.1038/s41598-024-65009-0