Category: Nevin Manimala

J Perinat Med. 2023 Dec 13. doi: 10.1515/jpm-2023-0211. Online ahead of print.

ABSTRACT

OBJECTIVES: To use saline infusion sonohysterography (SIS) to evaluate the effect of uterine closure technique on niche formation after multiple cesarean deliveries (CDs).

METHODS: Patients with at least one prior CD were evaluated for niche via SIS. Subgroups of any number repeat CD (>1 prior), lower-order CD (<4 prior), and higher-order CD (≥4 prior) were analyzed, stratifying by hysterotomy closure technique at last cesarean preceding imaging; techniques included Technique A (endometrium-free double-layer closure) and Technique B (single- or double-layer routine endo-myometrial closure). Niche defects were quantified (depth, length, width, and residual myometrial thickness). The primary outcome was clinically significant niche, defined as depth >2 mm. Statistical analysis was performed using chi-square, ANOVA, t-test, Kruskal-Wallis, and multiple logistic regression, with p-values of <0.05 were statistically significant.

RESULTS: A total of 172 post-cesarean SIS studies were reviewed: 105 after repeat CDs, 131 after lower-order CDs, and 41 after higher-order CDs. Technique A was associated with a shorter interval to imaging and more double-layer closures. Technique B was associated with more clinically significant niches across all subgroups, and these niches were significantly longer and deeper when present. Multiple logistic regression demonstrated a 5.6, 8.1, and 11-fold increased adjusted odds of clinically significant niche following Technique B closure in the repeat CD (p<0.01), lower-order CD (p<0.001), and higher-order CD (p=0.04) groups, respectively.

CONCLUSIONS: While multiple CDs are known to increase risk for niche defects and their sequelae, hysterotomy closure technique may help to reduce niche development and severity.

PMID:38081042 | DOI:10.1515/jpm-2023-0211

West J Med Phys Sci. 1838 Apr-Jun;6(1):149-150.

NO ABSTRACT

PMID:38080888 | PMC:PMC10470978

West J Med Phys Sci. 1833 Jul-Sep;1(2):161-181.

NO ABSTRACT

PMID:38080776 | PMC:PMC10467859

N Am Medchir Rev. 1858 Mar;2(2):334-340.

NO ABSTRACT

PMID:38080312 | PMC:PMC10348215

N Am Medchir Rev. 1861 Sep;5(5):927-937.

NO ABSTRACT

PMID:38080064 | PMC:PMC10344228

N Am Medchir Rev. 1860 Jul;4(4):656-692.

NO ABSTRACT

PMID:38080035 | PMC:PMC10344187

Chaos. 2023 Dec 1;33(12):121101. doi: 10.1063/5.0176358.

ABSTRACT

Chaos is an important dynamic feature, which generally occurs in deterministic and stochastic nonlinear systems and is an inherent characteristic that is ubiquitous. Many difficulties have been solved and new research perspectives have been provided in many fields. The control of chaos is another problem that has been studied. In recent years, a recurrent neural network has emerged, which is widely used to solve many problems in nonlinear dynamics and has fast and accurate computational speed. In this paper, we employ reservoir computing to control chaos in dynamic systems. The results show that the reservoir calculation algorithm with a control term can control the chaotic phenomenon in a dynamic system. Meanwhile, the method is applicable to dynamic systems with random noise. In addition, we investigate the problem of different values for neurons and leakage rates in the algorithm. The findings indicate that the performance of machine learning techniques can be improved by appropriately constructing neural networks.

PMID:38079650 | DOI:10.1063/5.0176358

Chaos. 2023 Dec 1;33(12):123114. doi: 10.1063/5.0168400.

ABSTRACT

The correlation dimension (CD) is a nonlinear measure of the complexity of invariant sets. First introduced for describing low-dimensional chaotic attractors, it has been later extended to the analysis of experimental electroencephalographic (EEG), magnetoencephalographic (MEG), and local field potential (LFP) recordings. However, its direct application to high-dimensional (dozens of signals) and high-definition (kHz sampling rate) 2HD data revealed a controversy in the results. We show that the need for an exponentially long data sample is the main difficulty in dealing with 2HD data. Then, we provide a novel method for estimating CD that enables orders of magnitude reduction of the required sample size. The approach decomposes raw data into statistically independent components and estimates the CD for each of them separately. In addition, the method allows ongoing insights into the interplay between the complexity of the contributing components, which can be related to different anatomical pathways and brain regions. The latter opens new approaches to a deeper interpretation of experimental data. Finally, we illustrate the method with synthetic data and LFPs recorded in the hippocampus of a rat.

PMID:38079645 | DOI:10.1063/5.0168400

Ann Intern Med. 2023 Dec 12. doi: 10.7326/M23-1345. Online ahead of print.

ABSTRACT

BACKGROUND: Prediction of atherosclerotic cardiovascular disease (ASCVD) in primary prevention assessments exclusively with laboratory results may facilitate automated risk reporting and improve uptake of preventive therapies.

OBJECTIVE: To develop and validate sex-specific prediction models for ASCVD using age and routine laboratory tests and compare their performance with that of the pooled cohort equations (PCEs).

DESIGN: Derivation and validation of the CANHEART (Cardiovascular Health in Ambulatory Care Research Team) Lab Models.

SETTING: Population-based cohort study in Ontario, Canada.

PARTICIPANTS: A derivation and internal validation cohort of adults aged 40 to 75 years without cardiovascular disease from April 2009 to December 2015; an external validation cohort of primary care patients from January 2010 to December 2014.

MEASUREMENTS: Age and laboratory predictors measured in the outpatient setting included serum total cholesterol, high-density lipoprotein cholesterol, triglycerides, hemoglobin, mean corpuscular volume, platelets, leukocytes, estimated glomerular filtration rate, and glucose. The ASCVD outcomes were defined as myocardial infarction, stroke, and death from ischemic heart or cerebrovascular disease within 5 years.

RESULTS: Sex-specific models were developed and internally validated in 2 160 497 women and 1 833 147 men. They were well calibrated, with relative differences less than 1% between mean predicted and observed risk for both sexes. The c-statistic was 0.77 in women and 0.71 in men. External validation in 31 697 primary care patients showed a relative difference less than 14% and an absolute difference less than 0.3 percentage points in mean predicted and observed risks for both sexes. The c-statistics for the laboratory models were 0.72 for both sexes and were not statistically significantly different from those for the PCEs in women (change in c-statistic, -0.01 [95% CI, -0.03 to 0.01]) or men (change in c-statistic, -0.01 [CI, -0.04 to 0.02]).

LIMITATION: Medication use was not available at the population level.

CONCLUSION: The CANHEART Lab Models predict ASCVD with similar accuracy to more complex models, such as the PCEs.

PRIMARY FUNDING SOURCE: Canadian Institutes of Health Research.

PMID:38079638 | DOI:10.7326/M23-1345

Appl Physiol Nutr Metab. 2023 Dec 11. doi: 10.1139/apnm-2023-0387. Online ahead of print.

ABSTRACT

There is a significant effect of sex and muscle mass on the cardiorespiratory response to the skeletal muscle metaboreflex during isometric exercise. We therefore tested the hypothesis that sex differences would be present when isolated following dynamic exercise. We also tested the hypothesis that single and double leg post-exercise circulatory occlusion (PECO) following high-intensity exercise would elicit a cardiorespiratory response proportional to the absolute muscle mass. Healthy (24±4 y) males (n=10) and females (n=10) completed pulmonary function and an incremental cycle test to exhaustion. Participants completed two randomized, 6-min bouts of intense cycle exercise (84±7 % V̇O2max). One exercise bout was immediately followed by 3-min post-exercise circulatory occlusion (PECO; 220 mmHg) of the legs while the other exercise bout was followed by passive recovery. Males completed an additional session of testing with single leg PECO. The mean arterial pressure during PECO was statistically greater in males compared to females (p=0.004). The heart rate response to PECO was similar between males compared with females (p=0.118). PECO elicited a greater ventilatory response in males compared with females (p=0.026). In males we observed a dose-dependent cardiovascular, but not ventilatory, response to muscle mass occluded (all p<0.05). Our findings suggest the metaboreflex contribution to cardiorespiratory control during dynamic exercise is greater in males compared to females. The ventilatory response induced by double-leg occlusion but not single-leg, suggests that the ventilatory influence of the metaboreflex is less sensitive than the cardiovascular response and may be linked to the greater afferent activation induced by double-leg occlusion.

PMID:38079618 | DOI:10.1139/apnm-2023-0387