Immediate impacts of COVID-19 vaccination on glycemic control in type 1 diabetes mellitus: a systematic review and meta-analysis.

Objective: COVID-19 vaccination is recommended in diabetic patients since diabetes is associated with worse clinical outcomes in COVID-19 infection. The safety profile of different types of COVID-19 vaccines, especially on glycemic control, can be explored due to availability of data from continuous glucose monitoring (CGM) devices. This meta-analysis aimed to quantify the impact of COVID-19 vaccination on glycemic control in patients with type 1 diabetes mellitus (T1DM). Methods: A systematic search of PubMed, Embase, and Google Scholar was conducted using a search strategy for studies published till January 2023 in English language. Comparative observational studies reporting glycemic control obtained from CGM before and after COVID-19 vaccination in T1DM patients were included. The primary outcome was time in range (TIR) metric of proportion of glucose results falling within the range: 3.9-10 mmol/l. Other outcomes were time above range (TAR) (>10 mmol/l), time below range (TBR) (<3.9 mmol/l), coefficient of variation (CV), and mean blood glucose levels. The pooled outcomes were compared pre-vaccination and post-vaccination using Hedges' g (HG) with 95% CI. Results: A total of seven studies (632 participants) were included in the meta-analysis. COVID-19 vaccination caused small and statistically insignificant decrease in TIR after both the first (HG = 0.21, 95% CI: -0.02 to 0.44, P=0.07) and second dose (HG = 0.09, 95% CI: -0.04 to 0.21, P = 0.19). Likewise, TAR was not affected after neither first (HG = -0.09, 95% CI: -0.22 to 0.03, P = 0.12) nor second vaccine dose (HG = -0.07, 95% CI: -0.21 to 0.06, P = 0.30). Likewise, TBR, mean blood glucose levels, and CV were not significantly altered following uptake of either of the doses. Conclusion: COVID-19 vaccination has an excellent safety profile in T1DM patients owing to its minimal impacts on immediate glycemic control.

A TLR7 Agonist Conjugated to a Nanofibrous Peptide Hydrogel as a Potent Vaccine Adjuvant.

Toll-like receptors (TLRs) recognize pathogen- and damage-associated molecular patterns and, in turn, trigger the release of cytokines and other immunostimulatory molecules. As a result, TLR agonists are increasingly being investigated as vaccine adjuvants, though many of these agonists are small molecules that quickly diffuse away from the vaccination site, limiting their co-localization with antigens and, thus, their effect. Here, the small-molecule TLR7 agonist 1V209 is conjugated to a positively-charged multidomain peptide (MDP) hydrogel, K 2 , which was previously shown to act as an adjuvant promoting humoral immunity. Mixing the 1V209-conjugated K 2 50:50 with the unfunctionalized K 2 produces hydrogels that retain the shear-thinning and self-healing physical properties of the original MDP, while improving the solubility of 1V209 more than 200-fold compared to the unconjugated molecule. When co-delivered with ovalbumin as a model antigen, 1V209-functionalized K 2 produces antigen-specific IgG titers that were statistically similar to alum, the gold standard adjuvant, and a significantly lower ratio of Th2-associated IgG1 to Th1-associated IgG2a than alum, suggesting a more balanced Th1 and Th2 response. Together, these results suggest that K 2 MDP hydrogels functionalized with 1V209 are a promising adjuvant for vaccines against infectious diseases, especially those benefiting from a combined Th1 and Th2 immune response. Table of Contents: Activation of toll-like receptors (TLRs) stimulates a signaling cascade to induce an immune response. A TLR7 agonist was conjugated to an injectable peptide hydrogel, which was then used to deliver a model vaccine antigen. This platform produced antibody titers similar to the gold standard adjuvant alum and demonstrated an improved balance between Th1- and Th2-mediated immunity over alum.

Rule-Based Text Classification of Dental Diagnosis.

Unstructured medical records boast an abundance of information that could greatly facilitate medical decision-making and improve patient care. With the development of Natural Language Processing (NLP) methodology, the free-text medical data starts to attract more and more research attention. Most existing studies try to leverage the power of such unstructured data using Machine Learning algorithms, which would usually require a relatively large training set, and high computational capacity. However, when faced with a smaller-scale project, opting for an alternative approach may be more effective and practical. This project proposes an efficient and light-weight rule-based approach to categorize dental diagnosis data. It not only fills the void of dental records in the medical free-text processing area, but also demonstrates that with expertly designed research structure and proper implementation, simple method could achieve our study goal very competently.

Lack of association of the alpha-ketoglutarate-dependent dioxygenase (FTO) gene polymorphisms with pulmonary tuberculosis risk: a systematic review and meta-analysis.

Objective: Our meta-analysis aims to explore the association of two single nucleotide variants; rs9939609 and rs8050136, within the FTO gene with risk of pulmonary tuberculosis (PTB). Methods: The association of two single nucleotide variants with PTB in three genetic models was evaluated using pooled odds ratios (ORs) with 95% CIs. Results: No significant association was observed between the rs9939609 polymorphism and PTB when assuming an allelic model (OR: 1.10; 95% CI: 0.85-1.41; P=0.47; I2 = 64.98%), a recessive model (OR: 2.04; 95% CI: 0.87-4.77; P=0.10; I2 = 67.18%), or a dominant model (OR: 0.96; 95% CI: 0.83-1.11; P=0.56; I2 = 27.45%). Likewise, no association was observed between rs8050136 polymorphism and PTB when assuming allelic model (OR: 1.17; 95% CI: 0.87-1.58; P=0.31; I2 = 64.20%) or recessive model (OR: 1.04; 95% CI: 0.32-3.38; P=0.95; I2 = 68.82%) or dominant model (OR: 1.22; 95% CI: 0.87-1.71; P=0.26; I2 = 58.69%). Conclusion: There might be no association between the rs9939609 and rs8050136 variants in the FTO gene, and the risk of PTB.

FEELing (key)Pressed: Implicit Touch Pressure Bests Brain Activity in Modelling Emotion Dynamics in the Space Between Stressed and Relaxed.

In-body lived emotional experiences can be complex, with time-varying and dissonant emotions evolving simultaneously; devices responding in real-time to estimate personal human emotion should evolve accordingly. Models assuming generalized emotions exist as discrete states fail to operationalize valuable information inherent in the dynamic and individualistic nature of human emotions. Our multi-resolution emotion self-reporting procedure allows the construction of emotion labels along the Stressed-Relaxed scale, differentiating not only what the emotions are, but how they are transitioning - e.g., "hopeful but getting stressed" vs. "hopeful and starting to relax". We trained participant-dependent hierarchical models of contextualized individual experience to compare emotion classification by modality (brain activity and keypress force from a physical keyboard), then benchmarked classification performance at F1-scores=[0.44, 0.82] (chance F1=0.22, σ = 0.01) and examined high-performing features. Notably, when classifying emotion evolution in the context of an experience that realistically varies in stress, pressure-based features from keypress force proved to be the more informative modality, and more convenient when considering intrusiveness and ease of collection and processing. Finally, we present our FEEL (Force, EEG and Emotion-Labelled) dataset, a collection of brain activity and keypress force data, labelled with self-reported emotion collected during tense videogame play (N=16) and open-sourced for community exploration.

Risk factors, lab parameters, angiographic characteristics and outcomes of coronary artery disease in young South Asian patients: a systematic review.

This systematic review provides a qualitative summary of the risk factors, angiographic characteristics, treatment, and complications of young South Asians with coronary artery disease (CAD). PubMed, Embase, and Google Scholar were searched to identify research articles published between 1 January 2010 and 13 November 2022. Studies in patients aged 18 to 45 years that were conducted in South Asian countries, were published in the English language, and included information on patients' clinical profiles and at least two risk factors for young CAD were included in the review. Smoking, dyslipidemia, high body mass index, increased high-sensitivity C-reactive protein, and hyperhomocysteinemia were observed in high proportions in young patients with CAD. Single-vessel disease was more common than multi-vessel disease in young CAD. The complications of CAD such as arrhythmias, cardiogenic shock, and heart failure were also commonly observed in young patients. Large-scale health promotion activities that curb modifiable risk factors such as smoking, obesity, and a sedentary lifestyle should be conducted in South Asian countries.

Diagnostic accuracy of Vibrational spectroscopy in the diagnosis of oral potentially malignant and malignant disorders: A systematic review and meta-analysis.

Oral malignant and potentially malignant conditions affect several people worldwide each year. The early diagnoses of these conditions play an important role in prevention and recovery. Vibrational spectroscopy techniques such as Raman spectroscopy (RS) and Fourier-transform infrared (FTIR) spectroscopy are used in the early, non-invasive, label-free diagnosis of malignant and pre-malignant conditions, and are areas of active research. However, there is no conclusive evidence suggesting the translatability of these methods into clinical practice. This systematic review and meta-analysis presents pooled evidence for RS and FTIR methods in the detection of malignant and potentially malignant conditions of the oral cavity. Electronic databases were searched for published literature on RS and FTIR in the diagnosis of oral malignant and potentially malignant conditions. The pooled sensitivity, specificity, diagnostic accuracy, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), pre-test, and post-test probability were then calculated using the random-effects model. A subgroup analysis was conducted separately for RS and FTIR methods. A total of 12 studies were included (8 of RS; 4 of FTIR) as per the eligibility criteria. The pooled sensitivity and specificity of the vibrational spectroscopy methods were calculated to be 0.99 (95% confidence interval [CI]: 0.90, 1.00) and 0.94 (95% CI: 0.85, 0.98), respectively. The area under the curve (AUC) for the summary receiving operator characteristic curve was found to be 0.99 (0.98-1.00). Therefore, the results obtained in this study suggest that the RS and FTIR methods offer great potential to be used in the early diagnosis of oral malignant and pre-malignant conditions.

Precision medicine and implications in medical education.

Precision medicine (PM) is a revolutionary approach that gathers and analyzes massive amounts of data on patient's history, lifestyle, genetic, and environmental factors to tailor the most effective treatment for the patient. The low utilization of PM in healthsector today can be tackled with the introduction of PM in medical education. In near future, medical education will observe gradual integration of PM in undergraduate and postgraduate curricula. The increased need of training of faculties, protection of patient's data and the use of advanced technologies are the likely ramifications of introduction of PM in medical education and healthcare.

Utility of neutrophil-to-high-density lipoprotein-cholesterol ratio in patients with coronary artery disease: a narrative review.

The neutrophil-to-high-density lipoprotein-cholesterol ratio (NHR) is thought to reflect inflammatory status and dyslipidaemia, both of which play significant roles in coronary artery disease (CAD). The objective of this narrative review is to summarise the results of studies that have explored the utility of NHR for the diagnosis and management of CAD. The PubMed, Google Scholar, Scopus, Embase and Web of Science databases were searched for articles related to NHR from their inception to October 2022. Seven relevant articles were obtained for review. There were unclear relationships of NHR with age, sex, smoking status, hypertension and diabetes. However, NHR had a sensitivity and specificity as high as 94.8% and 59%, respectively, for the identification of significant coronary stenosis. NHR was also a superior predictor of prognosis to conventional parameters. NHR had a sensitivity and specificity as high as 77.6% and 74.2%, respectively, for the prediction of adverse events, including mortality, associated with acute coronary syndrome. Thus, NHR could be used in clinical cardiovascular medicine for risk stratification and the prediction of the short-term and long-term outcomes of CAD. However, more studies are required before a quantitative assessment of the efficacy of NHR for use in patient management can be completed.

Successful management of delayed presentation of massive paracetamol overdose in a resource-limited setting: A case report from Nepal.

We present a case of self-poisoning with a massive dose of paracetamol by a young Nepalese female patient who presented late to our emergency department. This report highlights the successful management of the patient with the extended use of N-acetylcysteine over 4 days and continuous supportive therapy as required. The case is an example of the management of delayed presentation of a massive paracetamol poisoning in a resource-limited setting, where intensive care units and hemodialysis facilities are not easily available. However, when available, massive poisoning should always be managed in continuous monitoring units under the expertise of a toxicologist.