Association of sleep quality with physical and psychological health indicators in overweight and obese rural Indians

Objective

To measure the association of sleep quality with physical (i.e., grip strength, functional mobility, balance) and psychological (depression, anxiety) health indicators in an overweight/obese population.

Methods

Baseline data of 2337 participants (1382 overweight/obese and 955 normal weight) from an aging cohort in rural southern India (CBR-SANSCOG) was analyzed retrospectively. Assessment tools included the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, dynamometry for Hand Grip Strength (HGS), Timed Up-and-Go (TUG) for functional mobility, Chair Stand Test (CST) for lower limb strength, Geriatric Depression scale (GDS-30) for depressive symptoms and Generalized Anxiety Disorder scale (GAD-7) for anxiety symptoms. Linear regression models, adjusted for known confounders, were used to examine the association of sleep quality with the health parameters in overweight/obese and normal-weight groups.

Results

In the fully adjusted model, higher global PSQI score was associated with higher TUG time (β = 0.06, 95 % CI: 0.004,0.12), higher scores on GDS (β = 1.08, 95 % CI: 0.96,1.20) and GAD (β = 0.71, 95 % CI: 0.62,0.79), and lower scores on CST (β = -0.12, 95 % CI: -0.19,-0.06) in overweight/obese individuals. The sleep disturbance sub-component of PSQI was associated with most of the physical (TUG, CST) and psychological (GDS and GAD) health indicators. Sleep duration and use of sleep medication showed no significant association with any of the health indicators.

Conclusion

The concurrent presence of poor sleep quality and overweight/obesity could worsen physical and psychological health in middle-aged and older adults. We highlight the importance of early detection and timely management of sleep problems in this population to reduce physical and psychological morbidities.

Measurable residual disease (MRD) dynamics in multiple myeloma and the influence of clonal diversity analyzed by artificial intelligence

Minimal residual disease (MRD) assessment is a known surrogate marker for survival in multiple myeloma (MM). Here, we present a single institution's experience assessing MRD by NGS of Ig genes and the long-term impact of depth of response as well as clonal diversity on the clinical outcome of a large population of MM patients; 482 MM patients at the University of California, San Francisco (UCSF) diagnosed from 2008 to 2020 were analyzed retrospectively. MRD assessment was performed by NGS. PFS curves were plotted by the Kaplan-Meier method. In the newly diagnosed group, 119 of 304, achieved MRD negativity at the level of 10-6 at least once. These patients had a prolonged PFS versus patients who were persistently MRD positive at different levels (p > 0.0001). In the relapsed disease group, 64 of 178 achieved MRD negativity at 10-6, and PFS was prolonged versus patients who remained MRD positive (p = 0.03). Three categories of MRD dynamics were defined by artificial intelligence: (A) patients with ≥3 consistently MRD negative samples, (B) patients with continuously declining but detectable clones, and (C) patients with either increasing or a stable number of clones. Groups A and B had a more prolonged PFS than group C (p < 10-7). Patients who were MRD positive and had not yet relapsed had a higher clonal diversity than those patients who were MRD positive and had relapsed. MRD dynamics can accurately predict disease evolution and drive clinical decision-making. Clonal Diversity could complement MRD assessment in the prediction of outcomes in MM.

Impact of Transforming Interface Geometry on Edge States in Valley Photonic Crystals

We investigate how altering the interface geometry from a zigzag to a glide plane interface between two topologically distinct valley Hall emulating photonic crystals (VPC), profoundly affects edge states. We experimentally observe a transition from gapless to gapped edge states, accompanied by the occurrence of slow light within the Brillouin zone, rather than at its edge. We numerically simulate the propagation and measure the transmittance of the modified edge states through a specially designed valley-conserving defect. The robustness to backscattering gradually decreases, suggesting a disruption of valley-dependent transport. We demonstrate the significance of interface geometry to gapless edge states in a VPC.

Is Quadriceps-Strengthening Exercises (QSE) in Medial-Compartment Knee Osteoarthritis with Neutral and Varus Malalignment a Paradox? - A Risk-Appraisal of Strength-Training on Disease Progression

Introduction

The present inquiry seeks to investigate whether the current regimens of QSEs (Quadriceps-Strengthening Exercises) aggravate the disease while mitigating symptoms.

Materials and methods

A comparative study was conducted on 32 patients with medial compartment osteoarthritis of knees. While the neutral group of 16 patients was constituted of those with an anatomical-lateral-femoro-tibial-angle (aFTA) 176-180º, varus group comprised an equal number of patients with an aFTA >180º. A home-based 12-week strength-training program involving weekly visits to hospital for supervised sessions was administered. The outcome measures were visual-analog-scale (VAS), medial patello-femoral joint tenderness (MPFJT), time-up-and-go-test (TUGT), stair-climb test, step test, WOMAC, IKDC scores, aFTA, hip-knee-ankle (HKA) angle, lateral-tibio-femoral-joint-separation (LTFJS), and horizontal-distance-from-centre-of-knee-to-Mikulicz-line.

Results

There was a significant increase in quadriceps strength (p<0.01) in both groups. Values for neutral group with VAS score (p=0.01), MPFJT (p=0.01), TUGT (p=0.01), timing of the stair climb test (p=0.01), WOMAC (p<0.01), and IKDC (p=0.03) were better compared to varus group with VAS score (p=0.13), MPFJT (p=0.03), TUGT (p=0.90), timing of stair climb test (p=0.68), WOMAC (p<0.02), and IKDC (p=0.05). Varus group also showed an increase in aFTA and LTFJS in 12 patients, increase in HKA in 11, and increase in horizontal distance from the centre of knee to the Mikulicz line in 7 patients.

Conclusion

The present study brings to the fore the paradoxical role played by QSEs in management of medial knee OA. While there is a radiological progression of the disease in both neutral and varus mal-aligned knees more so in the latter than the former.

Unlocking The Mysteries of DNA Adducts with Artificial Intelligence

Cellular genome is considered a dynamic blueprint of a cell since it encodes genetic information that gets temporally altered due to various endogenous and exogenous insults. Largely, the extent of genomic dynamicity is controlled by the trade-off between DNA repair processes and the genotoxic potential of the causative agent (genotoxins or potential carcinogens). A subset of genotoxins form DNA adducts by covalently binding to the cellular DNA, triggering structural or functional changes that lead to significant alterations in cellular processes via genetic (e. g., mutations) or non-genetic (e. g., epigenome) routes. Identification, quantification, and characterization of DNA adducts are indispensable for their comprehensive understanding and could expedite the ongoing efforts in predicting carcinogenicity and their mode of action. In this review, we elaborate on using Artificial Intelligence (AI)-based modeling in adducts biology and present multiple computational strategies to gain advancements in decoding DNA adducts. The proposed AI-based strategies encompass predictive modeling for adduct formation via metabolic activation, novel adducts' identification, prediction of biochemical routes for adduct formation, adducts' half-life predictions within biological ecosystems, and, establishing methods to predict the link between adducts chemistry and its location within the genomic DNA. In summary, we discuss some futuristic AI-based approaches in DNA adduct biology.

Cost-effectiveness of a real-time spatiotemporal mapping surveillance system for meticillin-resistant Staphylococcus aureus prevention

OBJECTIVES

An infection surveillance system based on a hospital's digital twin [4D-Disease Outbreak Surveillance System (4D-DOSS)] is being developed in Singapore. It offers near-real-time infection surveillance and mapping capabilities. This early economic modelling study was conducted, using meticillin-resistant Staphylococcus aureus (MRSA) as the pathogen of interest, to assess the potential cost-effectiveness of 4D-DOSS.

METHODS

A Markov model that simulates the likelihood of MRSA colonization and infection was developed to evaluate the cost-effectiveness of adopting 4D-DOSS for MRSA surveillance from the hospital perspective, compared with current practice. The cycle duration was 1 day, and the model horizon was 30 days. Probabilistic sensitivity analysis was conducted, and the probability of cost-effectiveness was reported. Scenario analyses and a value of information analysis were performed.

RESULTS

In the base-case scenario, with 10-year implementation/maintenance costs of 4D-DOSS of $0, there was 68.6% chance that 4D-DOSS would be cost-effective. In a more pessimistic but plausible scenario where the effectiveness of 4D-DOSS in reducing MRSA transmission was one-quarter of the base-case scenario with 10-year implementation/maintenance costs of $1 million, there was 47.7% chance that adoption of 4D-DOSS would be cost-effective. The value of information analysis showed that uncertainty in MRSA costs made the greatest contribution to model uncertainty.

CONCLUSIONS

This early-stage modelling study revealed the circumstances for which 4D-DOSS is likely to be cost-effective at the current willingness-to-pay threshold, and identified the parameters for which further research will be worthwhile to reduce model uncertainty. Inclusion of other drug-resistant organisms will provide a more thorough assessment of the cost-effectiveness of 4D-DOSS.

Curriculum-based Faculty Training in Networking: Knowledge and Self-efficacy Outcomes

Although the advantages of developmental networks are well-known, most faculty do not know how to participate in such networks actively. Additionally, institutions face challenges in teaching faculty the best practices of networking. This deficiency constitutes a critical gap in the literature, which may slow career advancement for faculty, particularly from underrepresented groups. The study's purpose was to examine the effectiveness of a curriculum-based faculty training in developmental networks, utilizing the Extension for Community Health Outcomes (ECHO) platform. In this pre-post study, 33 faculty members participated in the intervention utilizing eight modules involving four competencies. Each module followed a standard format, including a short didactic, two facilitated case study discussions based on real-life scenarios, and self-reading of selected literature. Outcomes included (i) change in knowledge scores obtained from two questions per module and (ii) self-efficacy scores measured on a scale of 0-100. Paired student's t-test and mixed model regression analyses were used. A significant increase in knowledge score was documented using mixed model regression for 4 of the eight modules (mean change score 0.4-0.8, p≤0.03 for all analyses). The proportion of faculty participants reporting correct knowledge items for all modules increased from 49.8% (pre) to 64.3% (post), which was statistically significant (p<0.001). Significant increases in paired self-efficacy scores were reported for each of the eight modules (mean change score 17-37, p<0.05 for all analyses). This study highlights the importance of curriculum-based training in networking. Participants showed a significant increase in pre-post networking self-efficacy and knowledge scores. Our ECHO-based curriculum, facilitator training, and manual enable easy implementation in other institutions, ensuring scalability and adaptability. Our analysis provides the evidence basis for examining the impact of a developmental network intervention in enhancing individual career networks.

Inhibition of EphA3 Expression in Tumour Stromal Cells Suppresses Tumour Growth and Progression

Tumour progression relies on interactions with untransformed cells in the tumour microenvironment (TME), including cancer-associated fibroblasts (CAFs), which promote blood supply, tumour progression, and immune evasion. Eph receptor tyrosine kinases are cell guidance receptors that are most active during development but re-emerge in cancer and are recognised drug targets. EphA3 is overexpressed in a wide range of tumour types, and we previously found expression particularly in stromal and vascular tissues of the TME. To investigate its role in the TME, we generated transgenic mice with inducible shRNA-mediated knockdown of EphA3 expression. EphA3 knockdown was confirmed in aortic mesenchymal stem cells (MSCs), which displayed reduced angiogenic capacity. In mice with syngeneic lung tumours, EphA3 knockdown reduced vasculature and CAF/MSC-like cells in tumours, and inhibited tumour growth, which was confirmed also in a melanoma model. Single cell RNA sequencing analysis of multiple human tumour types confirmed EphA3 expression in CAFs, including in breast cancer, where EphA3 was particularly prominent in perivascular- and myofibroblast-like CAFs. Our results thus indicate expression of the cell guidance receptor EphA3 in distinct CAF subpopulations is important in supporting tumour angiogenesis and tumour growth, highlighting its potential as a therapeutic target.

Coordination of floral and fiber development in cotton (Gossypium) by hormone- and flavonoid-signalling associated regulatory miRNAs

Various plant development activities and stress responses are tightly regulated by various microRNAs (miRNA) and their target genes, or transcription factors in a spatiotemporal manner. Here, to exemplify how flowering-associated regulatory miRNAs synchronize their expression dynamics during floral and fiber development in cotton, constitutive expression diminution transgenic lines of auxin-signaling regulatory Gh-miR167 (35S-MIM167) were developed through target mimicry approach. 'Moderate' (58% to 80%)- and 'high' (> 80%)-Gh-miR167 diminution mimic lines showed dosage-dependent developmental deformities in anther development, pollen maturation, and fruit (= boll) formation. Cross pollination of 'moderate' 35S-MIM167 mimic lines with wild type (WT) plant partially restored boll formation and emergence of fiber initials on the ovule surface. Gh-miR167 diminution favored organ-specific transcription biases in miR159, miR166 as well as miR160, miR164, and miR172 along with their target genes during anther and petal development, respectively. Similarly, accumulative effect of percent Gh-miR167 diminution, cross regulation of its target ARF6/8 genes, and temporal mis-expression of hormone signaling- and flavonoid biosynthesis-associated regulatory miRNAs at early fiber initiation stage caused irregular fiber formation. Spatial and temporal transcription proportions of regulatory miRNAs were also found crucial for the execution of hormone- and flavonoid-dependent progression of floral and fiber development. These observations discover how assorted regulatory genetic circuits get organized in response to Gh-miR167 diminution and converge upon ensuing episodes of floral and fiber development in cotton.

Production and characterization of sustainable vermimanure derived from poultry litter and rice straw using tiger worm Eisenia fetida

Poultry litter (PL) and rice straw (RS), commonly available waste materials, pose severe threat to environment, if not properly managed. As viable waste treatment method, vermi-transformation of PL into enriched vermimanure was done using RS and cow dung (CD) with different feedstocks (FS) combinations like FS0_{(CD without earthworm),} FS1_(CD), FS2_{(1CD: 1RS)}, FS3_{(1CD: 1PL)} and FS4_{(1CD: 1RS: 1PL)} for 110 days. Increased growth performance (P < 0.05) of Eisenia fetida, macronutrient levels, and a consistently lower carbon-to-nitrogen ratio (C/N) emphasize the importance of RS and PL in the vermimanuring process. Several analytical techniques have revealed the presence of functional groups, nitrate (NO₃^-), phosphate (PO₄^3-), and potassium ions (K⁺) as well as the high porosity of the matured vermimanures. Therefore, using earthworms, the feedstock FS4_{(1CD: 1RS: 1PL)} could be successfully biotransformed into sustainable manure lowering the usage of chemical fertilizers and rice straw burning.

Performance analysis of U-Net with hybrid loss for foreground detection

With the latest developments in deep neural networks, the convolutional neural network (CNN) has made considerable progress in the area of foreground detection. However, the top-rank background subtraction algorithms for foreground detection still have many shortcomings. It is challenging to extract the true foreground against complex background. To tackle the bottleneck, we propose a hybrid loss-assisted U-Net framework for foreground detection. A proposed deep learning model integrates transfer learning and hybrid loss for better feature representation and faster model convergence. The core idea is to incorporate reference background image and change detection mask in the learning network. Furthermore, we empirically investigate the potential of hybrid loss over single loss function. The advantages of two significant loss functions are combined to tackle the class imbalance problem in foreground detection. The proposed technique demonstrates its effectiveness on standard datasets and performs better than the top-rank methods in challenging environment. Moreover, experiments on unseen videos also confirm the efficacy of proposed method.

Physical Therapy Interventions of an Electrical Burn Injury-Afflicted Patient: A Case Report

Electrical injuries are uncommon but not completely rare. It is most prevalent in the male population, although females are also affected in the workplace or household-related activities. These injuries usually occur in situations where proper precautions are not taken by the individual and also appropriate safety drills and education for personnel are not carried out. Electrical burns affecting children are very rare, but when they do occur, it is usually due to accidental contact with exposed electrical sources. In this patient, there were severe levels of secondary complications following the burn injury. The patient developed blood infections and also was hampered in doing a variety of activities of daily living. The patient was diagnosed with 45%-50% body surface area (BSA) covered with burns, which suggests its severe nature. Treatment focuses on preventing wound infection, managing the excruciating amount of pain, preventing complications of immobility, promoting mobility as much as the patient can, and also educating the patient and the family members.