Category: Nevin Manimala

Clin Ophthalmol. 2023 Aug 16;17:2405-2412. doi: 10.2147/OPTH.S407705. eCollection 2023.

ABSTRACT

PURPOSE: To determine the energy expenditure in phacoemulsification surgery expressed as cumulative dissipated energy (CDE) among the divide and conquer, ultrachopper-assisted divide and conquer, and phaco-chop techniques for dense cataract removal.

PATIENTS AND METHODS: The clinical data were obtained from the medical charts of dense cataracts patients undergoing routine phacoemulsification employing any of three phaco-fragmentation techniques, including divide and conquer using the Kelman 0.9 mm tip, the ultrachopper tip, and the phaco-chop technique using the Kelman 0.9 mm tip. Cumulated dissipated energy (CDE), longitudinal ultrasound time (UST), and endothelial cell loss were compared among groups at the one-month postoperative.

RESULTS: Surgeries from 90 eyes were analyzed, among whom the conventional divide-and-conquer technique group included 30 patients, 32 in the ultrachopper group, and 28 in the phaco-chop technique group. The average CDE in the conventional divide and conquer group was 44.52 ± 23.00, the ultrachopper technique was 43.27 ± 23.18, and 20.11 ± 11.06 in the phaco-chop group. Phaco-fragmentation chop demonstrated significantly lower CDE than the other techniques (p= <0.0001). The phaco-chop technique showed statistically significantly lower CDE when compared to the other two groups (p=<0.0001) with 93.96 ± 39.71 seconds. There were no statistically significant differences in postoperative endothelial cell density between groups (p=0.4916).

CONCLUSION: The use of the phaco-chop technique in hard cataract phacoemulsification represents a lower energy expenditure than divide and conquer and ultrachopper techniques; nevertheless, no differences regarding endothelial density loss were evidenced.

PMID:37605764 | PMC:PMC10440113 | DOI:10.2147/OPTH.S407705

Clin Interv Aging. 2023 Aug 16;18:1351-1359. doi: 10.2147/CIA.S411170. eCollection 2023.

ABSTRACT

PURPOSE: Impaired respiratory muscle strength has been associated with some geriatric syndromes. However, no studies have previously evaluated the relationship between respiratory muscle strength and dynapenic abdominal obesity. This study aimed to analyze whether there is an association between respiratory muscle strength and abdominal obesity, dynapenia and dynapenic abdominal obesity (DAO) in community-dwelling older adults.

PATIENTS AND METHODS: Cross-sectional study conducted with community-dwelling older adults (n=382 / 70.03 ± 7.3 years) from Macapá, Amapá, Brazil. Respiratory muscle strength was assessed by measuring maximal inspiratory and expiratory pressures (MIP and MEP, respectively), using an analog manovacuometry. DAO was defined as the combination of dynapenia (grip strength < 26 kgf for men and < 16 kgf for women) and abdominal obesity (abdominal circumference > 102 cm for men and > 88 cm for women). We performed descriptive and inferential statistical analyses using the student’s t-test for independent and related samples and linear regression model.

RESULTS: Older adults with abdominal obesity, dynapenia, and DAO presented lower mean values (obtained and obtained versus predicted; except abdominal obesity versus MIP) for maximal respiratory pressures compared to individuals without these conditions. However, the adjusted analysis only indicated an association between MIP and the following conditions: dynapenia (MIP – β =-0.171; p<0.001), abdominal obesity (MIP – β=0.102; p=0.042), and DAO (MIP – β=-0.101; p=0.028).

CONCLUSION: Older adults with abdominal obesity, dynapenia, and DAO showed impaired maximal respiratory pressures. The results of the adjusted analysis indicate that inspiratory muscle strength may require greater attention by health professionals aiming at preventing respiratory complications and improving respiratory health care in older people with these conditions.

PMID:37605751 | PMC:PMC10440087 | DOI:10.2147/CIA.S411170

PeerJ. 2023 Aug 17;11:e15545. doi: 10.7717/peerj.15545. eCollection 2023.

ABSTRACT

Geometric morphometrics is widely used to quantify morphological variation between biological specimens, but the fundamental influence of operator bias on data reproducibility is rarely considered, particularly in studies using photographs of live animals taken under field conditions. We examined this using four independent operators that applied an identical landmarking scheme to replicate photographs of 291 live Atlantic salmon (Salmo salar L.) from two rivers. Using repeated measures tests, we found significant inter-operator differences in mean body shape, suggesting that the operators introduced a systematic error despite following the same landmarking scheme. No significant differences were detected when the landmarking process was repeated by the same operator on a random subset of photographs. Importantly, in spite of significant operator bias, small but statistically significant morphological differences between fish from the two rivers were found consistently by all operators. Pairwise tests of angles of vectors of shape change showed that these between-river differences in body shape were analogous across operator datasets, suggesting a general reproducibility of findings obtained by geometric morphometric studies. In contrast, merging landmark data when fish from each river are digitised by different operators had a significant impact on downstream analyses, highlighting an intrinsic risk of bias. Overall, we show that, even when significant inter-operator error is introduced during digitisation, following an identical landmarking scheme can identify morphological differences between populations. This study indicates that operators digitising at least a sub-set of all data groups of interest may be an effective way of mitigating inter-operator error and potentially enabling data sharing.

PMID:37605749 | PMC:PMC10440062 | DOI:10.7717/peerj.15545

J Pain Res. 2023 Aug 16;16:2835-2845. doi: 10.2147/JPR.S419682. eCollection 2023.

ABSTRACT

PURPOSE: The primary objective of this study is to determine if ultrasound-guided erector spinae plane blocks (ESPB) prior to thoracolumbar spinal fusion reduces opioid consumption in the first 24 hours postoperatively. Secondary objectives include ESPB effects on administration of opioids, utilization of intravenous patient-controlled analgesia (IV-PCA), pain scores, length of stay, and opioid related side effects.

METHODS: A retrospective cohort analysis was performed on consecutive, adult patients undergoing primary thoracolumbar fusion procedures. Demographic and baseline characteristics including diagnoses of chronic pain, anxiety, depression, and preoperative use of opioids were collected. Surgical data included surgical levels, opioid administration, and duration. Postoperative data included pain scores, opioid consumption, IV-PCA duration, opioid-related side effects, ESPB-related complications, and length of stay (LOS). Statistical analysis was performed using chi-squared and t-test analyses, multivariable analysis, and covariate adjustment with propensity score.

RESULTS: A total of 118 consecutive primary thoracolumbar fusions were identified between October 2019 and December 2021 (70 ESPB, 48 no-block [NB]). There were no significant demographic or surgical differences between groups. Median surgical time (262.50 mins vs 332.50 mins, p = 0.04), median intraoperative opioid consumption (8.11 OME vs 1.73 OME, p = 0.01), and median LOS (152.00 hrs vs 128.50 hrs, p = 0.01) were significantly reduced in the ESPB group. Using multivariable covariate adjustment with propensity score analysis only intraoperative opioid administration was found to be significantly less in the ESPB cohort.

CONCLUSION: ESPB for thoracolumbar fusion can be performed safely in index cases. There was a reduction of intraoperative opioid administration in the ESPB group, however the care team was not blinded to the intervention. Extensive thoracolumbar spinal fusion surgery may require a different approach to regional anesthesia to be similarly effective as ESPB in isolated lumbar surgeries.

PMID:37605744 | PMC:PMC10440116 | DOI:10.2147/JPR.S419682

Int J Mol Cell Med. 2022;11(3):244-259. doi: 10.22088/IJMCM.BUMS.11.3.244.

ABSTRACT

Current cancer therapies include chemotherapy, radiation therapy, immunotherapy, and surgery. Despite these treatment methods, a major point in cancer treatment is early detection. RNAs (mRNA, miRNAs, and LncRNA) can be used as markers to improve cancer diagnosis and treatment. This research examined how radiotherapy affected CCL5, miR-214, and MALAT-1 gene expression in the immune pathway in peripheral blood samples from radiation therapy-treated breast cancer patients. Before and after radiotherapy, peripheral blood was collected from 15 patients in four steps. Blood samples were collected in an outpatient facility from 20 healthy female volunteers with no history of malignant or inflammatory conditions. RNA was extracted from the blood samples and cDNA was synthesized. CCL5, miR-214, and MALAT-1 gene expression were determined by real-time polymerase chain reaction (RT-PCR). CCL5 protein levels in the serum were determined in 80 samples (60 BC and 20 healthy controls) using Quantikine Enzyme-Linked Immunosorbent Assay (ELISA) kits (R&D Systems). The data were then statistically evaluated. There was a significant difference between CCL5 levels in tumoral and adjacent normal blood samples (p < 0.05). The results also show that the level of gene expression and serum concentration of CCL5 protein in different phases of radiotherapy is significantly different. On the other hand, the expression level of the miR-214 gene was significantly decreased in patients compared to the control group, but this decrease was not significant for the MALAT-1 gene (p< 0.05). Also, after each stage of radiotherapy, the expression level of these two genes showed a decrease, but in the fourth week after radiotherapy, this decrease was significant (p< 0.05). Radiotherapy is associated with a decrease in the expression of miR-214 and MALAT-1, as a result, an increase in the expression of CCL5. An increase in the concentration of CCL5 protein is accompanied by an increase in the level of monocytes, which ultimately causes the infiltration of macrophages and can ultimately cause cancer recurrence. It is suggested that these genes can probably be used as diagnostic and therapeutic radiotherapy markers in breast cancer.

PMID:37605739 | PMC:PMC10440003 | DOI:10.22088/IJMCM.BUMS.11.3.244

BMC Med Res Methodol. 2023 Aug 21;23(1):190. doi: 10.1186/s12874-023-02013-4.

ABSTRACT

BACKGROUND: The Naive Bayes (NB) classifier is a powerful supervised algorithm widely used in Machine Learning (ML). However, its effectiveness relies on a strict assumption of conditional independence, which is often violated in real-world scenarios. To address this limitation, various studies have explored extensions of NB that tackle the issue of non-conditional independence in the data. These approaches can be broadly categorized into two main categories: feature selection and structure expansion. In this particular study, we propose a novel approach to enhancing NB by introducing a latent variable as the parent of the attributes. We define this latent variable using a flexible technique called Bayesian Latent Class Analysis (BLCA). As a result, our final model combines the strengths of NB and BLCA, giving rise to what we refer to as NB-BLCA. By incorporating the latent variable, we aim to capture complex dependencies among the attributes and improve the overall performance of the classifier.

METHODS: Both Expectation-Maximization (EM) algorithm and the Gibbs sampling approach were offered for parameter learning. A simulation study was conducted to evaluate the classification of the model in comparison with the ordinary NB model. In addition, real-world data related to 976 Gastric Cancer (GC) and 1189 Non-ulcer dyspepsia (NUD) patients was used to show the model’s performance in an actual application. The validity of models was evaluated using the 10-fold cross-validation.

RESULTS: The presented model was superior to ordinary NB in all the simulation scenarios according to higher classification sensitivity and specificity in test data. The NB-BLCA model using Gibbs sampling accuracy was 87.77 (95% CI: 84.87-90.29). This index was estimated at 77.22 (95% CI: 73.64-80.53) and 74.71 (95% CI: 71.02-78.15) for the NB-BLCA model using the EM algorithm and ordinary NB classifier, respectively.

CONCLUSIONS: When considering the modification of the NB classifier, incorporating a latent component into the model offers numerous advantages, particularly within medical and health-related contexts. By doing so, the researchers can bypass the extensive search algorithm and structure learning required in the local learning and structure extension approach. The inclusion of latent class variables allows for the integration of all attributes during model construction. Consequently, the NB-BLCA model serves as a suitable alternative to conventional NB classifiers when the assumption of independence is violated, especially in domains pertaining to health and medicine.

PMID:37605107 | DOI:10.1186/s12874-023-02013-4

J Community Health. 2023 Aug 21. doi: 10.1007/s10900-023-01270-0. Online ahead of print.

ABSTRACT

Aim was to investigate the amount of smoking in popular streaming series in Germany with a focus on the comparison between series recommended for adults versus youth. The sample was drawn from the 35 highest user-rated streaming series, that released 1794 new episodes between January 1, 2017 and December 31, 2020. One-third of the episodes (N = 598) were randomly selected and analyzed for smoking content. The age ratings of these episodes ranged from 6 to 18 years, with categories of “6”, “12”, “16” and “18” years. Ten of the 35 shows (28.6%) were completely smoke-free, 25 shows (71.4%) had at least one episode with smoking. Of all analyzed episodes, 25.1% contained smoking (range = 1 to 36 smoking scenes; median = 4). There was a statistically significant association between episode age rating and the presence of smoking (χ²[3] = 9.1; p = 0.028; Spearman’s rho = 0.11): The proportion of episodes with smoking was 0% for episodes with age ratings below 12 years, 20.4% for age ratings “12”, 28.3% for age ratings “16”, and 32.4% for age ratings “18”. This association differed between streaming services, but all services had smoking in episodes rated for youth. Smoking is common in popular streaming series. None of the streaming services meet the recommendations of the WHO Framework Convention on Tobacco Control to reliably restrict young people’s access to media content that depicts smoking.

PMID:37605099 | DOI:10.1007/s10900-023-01270-0

Cardiovasc Intervent Radiol. 2023 Aug 21. doi: 10.1007/s00270-023-03532-9. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate rates of fibroid expulsion after uterine artery embolization (UAE) and risk factors.

MATERIALS AND METHODS: Single-center retrospective study of UAEs for fibroids between 2016 and 2020. Preoperative UAE and patients with incomplete follow-up were excluded. Patients underwent MRI before and 3 months after UAE and/or as indicated. Medical records were reviewed, and patient demographics, fibroid characteristics and clinical events were recorded. Fibroid expulsion included fibroid exposure to the endometrial cavity on MRI, and tissue loss/passage as observed clinically or on MRI. Symptoms were considered major if requiring additional clinic visits or treatment. Statistical tests included Chi-square, Fisher’s exact test, and logistic regression models.

RESULTS: One hundred ninety-nine women were included. Symptomatic fibroid expulsion occurred after 31 (16%) procedures: 16 minor and 15 major. Symptoms included vaginal discharge (n = 23), bleeding (n = 9), tissue passage (n = 9), cramping/pain (n = 3), and fever (n = 4). Fifteen women (8%) needed additional care, of whom 6 (3%) required invasive procedures (4 elective hysterectomies, 1 hysteroscopic resection, 1 transvaginal removal of passing tissue). The International Federation of Gynecology and Obstetrics (FIGO) classification was significantly associated with symptomatic fibroid expulsion (p = 0.001). Odds ratio for symptomatic expulsion and expulsion requiring additional care for FIGO 3-7 versus 0-2 fibroids was 0.32 (95% confidence interval, 0.14-0.71, p = 0.005) and 0.28 (95% confidence interval, 0.10-0.83, p = 0.02), respectively. Other factors were not consistently associated with expulsion.

CONCLUSION: Fibroid expulsion after uterine artery embolization was more common than previously reported but mostly asymptomatic or minimally symptomatic. Women with FIGO ≤ 2 fibroids should be appropriately counseled regarding risk for expulsion.

PMID:37605055 | DOI:10.1007/s00270-023-03532-9

Nat Hum Behav. 2023 Aug 21. doi: 10.1038/s41562-023-01655-0. Online ahead of print.

ABSTRACT

Do anonymous online conversations between people with different political views exacerbate or mitigate partisan polarization? We created a mobile chat platform to study the impact of such discussions. Our study recruited Republicans and Democrats in the United States to complete a survey about their political views. We later randomized them into treatment conditions where they were offered financial incentives to use our platform to discuss a contentious policy issue with an opposing partisan. We found that people who engage in anonymous cross-party conversations about political topics exhibit substantial decreases in polarization compared with a placebo group that wrote an essay using the same conversation prompts. Moreover, these depolarizing effects were correlated with the civility of dialogue between study participants. Our findings demonstrate the potential for well-designed social media platforms to mitigate political polarization and underscore the need for a flexible platform for scientific research on social media.

PMID:37604989 | DOI:10.1038/s41562-023-01655-0

Sci Rep. 2023 Aug 21;13(1):13593. doi: 10.1038/s41598-023-40903-1.

ABSTRACT

The California bearing ratio (CBR) is one of the basic subgrade strength characterization properties in road pavement design for evaluating the bearing capacity of pavement subgrade materials. In this research, a new model based on the Gaussian process regression (GPR) computing technique was trained and developed to predict CBR value of hydrated lime-activated rice husk ash (HARHA) treated soil. An experimental database containing 121 data points have been used. The dataset contains input parameters namely HARHA-a hybrid geometrical binder, liquid limit, plastic limit, plastic index, optimum moisture content, activity and maximum dry density while the output parameter for the model is CBR. The performance of the GPR model is assessed using statistical parameters, including the coefficient of determination (R²), mean absolute error (MAE), root mean square error (RMSE), Relative Root Mean Square Error (RRMSE), and performance indicator (ρ). The obtained results through GPR model yield higher accuracy as compare to recently establish artificial neural network (ANN) and gene expression programming (GEP) models in the literature. The analysis of the R² together with MAE, RMSE, RRMSE, and ρ values for the CBR demonstrates that the GPR achieved a better prediction performance in training phase with (R² = 0.9999, MAE = 0.0920, RMSE = 0.13907, RRMSE = 0.0078 and ρ = 0.00391) succeeded by the ANN model with (R² = 0.9998, MAE = 0.0962, RMSE = 4.98, RRMSE = 0.20, and ρ = 0.100) and GEP model with (R² = 0.9972, MAE = 0.5, RMSE = 4.94, RRMSE = 0.202, and ρ = 0.101). Furthermore, the sensitivity analysis result shows that HARHA was the key parameter affecting the CBR.

PMID:37604957 | DOI:10.1038/s41598-023-40903-1