Category: Nevin Manimala

Am J Speech Lang Pathol. 2023 May 31:1-13. doi: 10.1044/2023_AJSLP-22-00264. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to determine normative values for cepstral peak prominence measures across the life span as a function of sex using clinically relevant stimuli (/ɑ/, /i/, and two sentences of The Rainbow Passage) and two commonly used software types: Praat (Version 6.0.50) and Analysis of Dysphonia in Speech and Voice (ADSV).

METHOD: One hundred fifty speakers (75 men, 75 women; evenly distributed into three age groups) without voice disorders aged 18-91 years were recorded via headset microphone in a sound-treated booth. Cepstral measures were analyzed using common analysis methods in Praat and ADSV by sex, stimuli, and software type. Kruskal-Wallis tests and post hoc Mood’s Median tests for significant factors were performed on cepstral measures to assess the effects of age group, sex, stimuli, and software type.

RESULTS: The results revealed statistically significant effects of sex, stimuli, and software type on cepstral measures, but no statistical effect of age group on cepstral values. Women had lower average cepstral values compared to men. Across stimuli, the highest average cepstral measure was found for sustained /ɑ/, followed by sustained /i/, and then of the two sentences of The Rainbow Passage. Average cepstral measures in Praat were higher than those from ADSV.

CONCLUSIONS: The current work did not find a statistical effect of age group on cepstral values; thus, normative cepstral values were reported by sex, stimuli, and software type. Future work should examine the applicability of these normative values for discriminating speakers with and without voice disorders.

PMID:37257202 | DOI:10.1044/2023_AJSLP-22-00264

Cancer Epidemiol Biomarkers Prev. 2023 May 31:EPI-23-0154. doi: 10.1158/1055-9965.EPI-23-0154. Online ahead of print.

ABSTRACT

Spatial modelling of cancer survival is an important tool for identifying geographic disparities and providing an evidence base for resource allocation. Many different approaches have attempted to understand how survival varies geographically. This is the first scoping review to describe different methods and visualization techniques and to assess temporal trends in publications. The review was carried out using the PRISMA guideline using PubMed and Web of Science databases. Two authors independently screened articles. Articles were eligible for review if they measured cancer survival outcomes in small geographical areas by using spatial regression and/or mapping. Thirty-two articles were included, and the number increased over time. Most articles have been conducted in high-income countries using cancer registry databases. Eight different methods of modelling spatial survival were identified, and there were seven different ways of visualizing the results. Increasing the use of spatial modelling through enhanced data availability and knowledge sharing could help inform and motivate efforts to improve cancer outcomes and reduce excess deaths due to geographical inequalities. Efforts to improve the coverage and completeness of population-based cancer registries should continue to be a priority, in addition to encouraging the open sharing of relevant statistical programming syntax and international collaborations.

PMID:37257201 | DOI:10.1158/1055-9965.EPI-23-0154

J Comput Biol. 2023 May 31. doi: 10.1089/cmb.2022.0388. Online ahead of print.

ABSTRACT

The stochastic susceptible-infected-vaccinated (SIV) epidemic model includes a nonlinear term, making it difficult to obtain analytical solutions. Thus, numerical approximation schemes are an important tool for predicting the dynamics of infectious diseases and establishing optimal control strategies. However, the convergence rate of the existing numerical methods [e.g., Euler-Maruyama (EM) and truncated EM scheme] is only 1/2 order of the time step $\Delta t$. This article describes the construction of a logarithmic truncated EM scheme that achieves order-1 convergence and ensures positive numerical solutions of the stochastic SIV epidemic model. The existence of an invariant measure is proved for the stochastic SIV epidemic model with Markov switching. In addition, relaxed controls for the stochastic SIV epidemic model are investigated by using the Markov chain approximation method. It is demonstrated that the approximation schemes converge to the optimal strategy as the mesh size goes to zero. Finally, the results of numerical examples are presented to illustrate the theoretical results derived in this article.

PMID:37257191 | DOI:10.1089/cmb.2022.0388

Genet Test Mol Biomarkers. 2023 May;27(5):149-156. doi: 10.1089/gtmb.2022.0201.

ABSTRACT

Objectives: This study was designed to analyze the association between the SLC2A2 rs1499821 polymorphism and caries susceptibility in the Chinese Han, Zhuang, and Baikuyao populations. Materials and Methods: The present case-control study included 1067 12-year-old children: 481 with caries (142 Han, 166 Zhuang and 173 Baikuyao) and 586 who were caries-free (135 Han, 178 Zhuang and 273 Baikuyao). Questionnaires about diet and oral habits were obtained from all subjects. All of the children received dental examinations and DNA collection. The SLC2A2 rs1499821 SNP was genotyped using the SNPscan technique. Results: The rs1499821 T polymorphism was significantly associated with caries susceptibility in both the Han population and the combined populations of the three ethnic subgroups. SLC2A2 rs1499821 was associated with caries susceptibility in the dominant model in the Han (p = 0.045) population and the combined (p = 0.038) group. The CT+TT genotypes at rs1499821 were associated with a higher risk of caries in the Han (OR = 1.69, adjusted 95% CI: 1.01-2.81) and combined (OR = 1.33, adjusted 95% CI: 1.02-1.74) populations. In both Han (p = 0.009) and the combined populations (p = 0.004), there were statistically significant associations between the frequency of sweet food intake and dental caries. However, the rs1499821 polymorphisms did not associate with the frequency of sweet food intake in these ethnic subgroups. Conclusion: In the Han population, the SLC2A2 rs1499821 T allele and the frequency of sweet food intake may be regarded as risk factors for caries susceptibility. The SLC2A2 rs1499821 T allele had no association with the frequency of sweet food intake in any of the three ethnic groups.

PMID:37257183 | DOI:10.1089/gtmb.2022.0201

Biostatistics. 2023 May 31:kxad010. doi: 10.1093/biostatistics/kxad010. Online ahead of print.

ABSTRACT

In complex tissues containing cells that are difficult to dissociate, single-nucleus RNA-sequencing (snRNA-seq) has become the preferred experimental technology over single-cell RNA-sequencing (scRNA-seq) to measure gene expression. To accurately model these data in downstream analyses, previous work has shown that droplet-based scRNA-seq data are not zero-inflated, but whether droplet-based snRNA-seq data follow the same probability distributions has not been systematically evaluated. Using pseudonegative control data from nuclei in mouse cortex sequenced with the 10x Genomics Chromium system and mouse kidney sequenced with the DropSeq system, we found that droplet-based snRNA-seq data follow a negative binomial distribution, suggesting that parametric statistical models applied to scRNA-seq are transferable to snRNA-seq. Furthermore, we found that the quantification choices in adapting quantification mapping strategies from scRNA-seq to snRNA-seq can play a significant role in downstream analyses and biological interpretation. In particular, reference transcriptomes that do not include intronic regions result in significantly smaller library sizes and incongruous cell type classifications. We also confirmed the presence of a gene length bias in snRNA-seq data, which we show is present in both exonic and intronic reads, and investigate potential causes for the bias.

PMID:37257175 | DOI:10.1093/biostatistics/kxad010

Am Surg. 2023 May 31:31348231180915. doi: 10.1177/00031348231180915. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with peritoneal carcinomatosis (PC) can develop malignant bowel obstructions (MBOs) requiring inpatient admission and nasogastric tube decompression. Palliative decompressive gastrostomy tubes (G-tubes) may affect patient disposition, allowing for self-management and reduction in inpatient services. Therefore, we sought to assess disposition and inpatient readmission rates in patients admitted with PC and MBO following G-tube placement.

METHODS: The Vizient® Clinical Data Base was queried for inpatient admissions from October 2018 to May 2022 utilizing ICD-10 codes to identify patients admitted with PC and bowel obstruction, with or without G-tube placement. Demographics and hospital outcomes were recorded. Descriptive statistics and multivariate logistic regression analysis were performed.

RESULTS: From 750 patients, 59 (7.9%) had a G-tube placed. Compared to patients without G-tubes, those with G-tubes had lower rates of disposition to home (32.2% vs 70.0%, P < .001) and higher rates of disposition to hospice (home: 30.5% vs 7.8%, P < .001, facility: 10.2% vs 3.9%, P = .02). There was no significant difference in the rate (17.3% vs 22.3%, P = .40) or risk (OR = 1.44, 95% CI .69-3.01) of 30-day readmissions with G-tubes. However, palliative care consultation (OR 33.77, 95% CI 19.16-59.52) and G-tube placement (OR 5.82, 95% CI 2.56-13.25) were independent predictors for hospice.

DISCUSSION: Placement of G-tubes in patients with PC and MBO was associated with higher rates of disposition to hospice but there is no difference in 30-day readmission rates compared to those without G-tubes. Further prospective studies are needed to understand the role of G-tube placement in patients with MBO in relation to outcomes and disposition.

PMID:37257144 | DOI:10.1177/00031348231180915

J Clin Oncol. 2023 May 31:JCO2202200. doi: 10.1200/JCO.22.02200. Online ahead of print.

ABSTRACT

PURPOSE: Blinatumomab, a bispecific T-cell engager immunotherapy, is efficacious in relapsed/refractory B-cell ALL (B-ALL) and has a favorable toxicity profile. One aim of the Children’s Oncology Group AALL1331 study was to compare survival of patients with low-risk (LR) first relapse of B-ALL treated with chemotherapy alone or chemotherapy plus blinatumomab.

PATIENTS AND METHODS: After block 1 reinduction, patients age 1-30 years with LR first relapse of B-ALL were randomly assigned to block 2/block 3/two continuation chemotherapy cycles/maintenance (arm C) or block 2/two cycles of continuation chemotherapy intercalated with three blinatumomab blocks/maintenance (arm D). Patients with CNS leukemia received 18 Gy cranial radiation during maintenance and intensified intrathecal chemotherapy. The primary and secondary end points were disease-free survival (DFS) and overall survival (OS).

RESULTS: The 4-year DFS/OS for the 255 LR patients accrued between December 2014 and September 2019 were 61.2% ± 5.0%/90.4% ± 3.0% for blinatumomab versus 49.5% ± 5.2%/79.6% ± 4.3% for chemotherapy (P = .089/P = .11). For bone marrow (BM) ± extramedullary (EM) (BM ± EM; n = 174) relapses, 4-year DFS/OS were 72.7% ± 5.8%/97.1% ± 2.1% for blinatumomab versus 53.7% ± 6.7%/84.8% ± 4.8% for chemotherapy (P = .015/P = .020). For isolated EM (IEM; n = 81) relapses, 4-year DFS/OS were 36.6% ± 8.2%/76.5% ± 7.5% for blinatumomab versus 38.8% ± 8.0%/68.8% ± 8.6% for chemotherapy (P = .62/P = .53). Blinatumomab was well tolerated and patients had low adverse event rates.

CONCLUSION: For children, adolescents, and young adults with B-ALL in LR first relapse, there was no statistically significant difference in DFS or OS between the blinatumomab and standard chemotherapy arms overall. However, blinatumomab significantly improved DFS and OS for the two thirds of patients with BM ± EM relapse, establishing a new standard of care for this population. By contrast, similar outcomes and poor DFS for both arms were observed in the one third of patients with IEM; new treatment approaches are needed for these patients (ClinicalTrials.gov identifier: NCT02101853).

PMID:37257143 | DOI:10.1200/JCO.22.02200

Plast Reconstr Surg. 2023 May 31. doi: 10.1097/PRS.0000000000010784. Online ahead of print.

ABSTRACT

BACKGROUND: Computer-assisted surgical simulation (CASS) allows more precise orthognathic surgery. However, few studies have evaluated associations between CASS-designed bilateral sagittal split osteotomy (BSSO) and bone contact surface in class II mandibular asymmetry. This study aims to evaluate the effects of using computer-assisted simulation and design modification of sagittal split osteotomy (SSO) to improve bony contact in skeletal class II asymmetry.

METHODS: This retrospective analysis reviewed 28 patients with class II asymmetry who underwent orthognathic surgery, including 15 with modified SSO (group CS) and 13 with conventional SSO (group C). Modified SSO was designed under CASS. Operative characteristics, postoperative outcomes, and complications were collected and compared between the two groups.

RESULTS: Bony contact was found at the distal end of the proximal segment in all group CS patients, while bone gap was noted in all group C patients (p<0.05). Moreover, bone graft was used in four group C patients but was not used in all cases group CS patients (p<0.05). A trend toward lower operative time or perioperative bleeding was noted in group CS, but without statistical significance. After 1-year follow-up, inferior alveolar nerve disturbances were noted in two group CS patients and one group C patient. Palpable bone gap with uneven jaw line was noted in two group C patients one year after surgery and one patient received fat graft treatment.

CONCLUSION: The simulation-based sagittal split osteotomy modification provides appropriate contact surface and eliminates the bone gap between proximal and distal segments in class II asymmetry.

PMID:37257138 | DOI:10.1097/PRS.0000000000010784

Plast Reconstr Surg. 2023 May 31. doi: 10.1097/PRS.0000000000010773. Online ahead of print.

ABSTRACT

BACKGROUND: It remains unclear if physiologic differences exist in musculoskeletal ultrasound nerve measurements when comparing bilateral and unilateral carpal tunnel syndrome (CTS) patients. Similarly, the influence of body mass index (BMI) on CTS severity is not well characterized.

METHODS: Unilateral and bilateral CTS patients were seen from October 2014-February 2021. Obese and non-obese CTS patients were compared. Median nerve cross-sectional area (CSA), Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) and CTS-6 measures were obtained. NCS recorded distal motor latency (DML) and distal sensory latency (DSL). Statistical analysis used the Wilcoxon signed-rank testing for paired continuous variables, Mann-Whitney U testing for non-paired continuous variables, and chi-squared for continuous variables with a significance level of p < 0.05.

RESULTS: 109 (218 nerves) bilateral and 112 (112 nerves) unilateral CTS patients were reviewed. Bilateral patients had larger median nerve CSAs on their more symptomatic side, when defined by BCTSQ score (p < 0.0001), CTS-6 score (p < 0.0001), DML (p < 0.0001), and DSL (p < 0.01). Bilateral patients also had higher symptom severity scale (p < 0.01) and DSL (p < 0.001) outcomes compared to unilateral. Obese patients had higher median nerve CSA (p < 0.01), prolonged DML, and DSL (p < 0.0001) values despite similar CTS severity (BCTSQ, CTS-6).

CONCLUSIONS: Ultrasound identifies the more symptomatic side in bilateral patients, which correlates with increasing severity (NCS, BCTSQ). Obesity increases median nerve CSA and prolongs NCS without influencing CTS severity. This information can be utilized when considering which diagnostic testing to order for CTS.

LEVEL OF EVIDENCE: Level 3 Diagnostic.

PMID:37257136 | DOI:10.1097/PRS.0000000000010773

Plast Reconstr Surg. 2023 May 31. doi: 10.1097/PRS.0000000000010785. Online ahead of print.

ABSTRACT

BACKGROUND: Children born with hemifacial microsomia (HFM) can suffer from airway compromise. There is a paucity of data correlating degree of HFM severity with airway difficulty. This study aims to determine the relationship between degree of micrognathia and airway insufficiency in the HFM population.

METHODS: Patient demographics, airway function, Kaban-Pruzansky (KP) grade, and Cormack Lehane (CL) grade were collected and compared with appropriate statistics for HFM patients treated between 2000 and 2022.

RESULTS: Seventy patients underwent 365 operations with KP grading as follows: 34% I, 23% IIA, 11% IIB, and 33% grade III. Goldenhar syndrome was present in 40% of patients and 16% had bilateral disease. KP grade (p<0.001) predicted mean number of airway-affecting procedures undergone and difficult airway status (p<0.001), with 75% of difficult airways in KP III patients. There was no association of airway compromise with Goldenhar syndrome, laterality, or age (p>0.05). Most CL grades were I (61%) or IIA (13%), with fewer IIB, III, and IV (4-7%). KP grade predicted CL grade (p<0.001), with 71% of grade IV views and 64% of grade III views seen in KP III patients.

CONCLUSIONS: Kaban-Pruzansky grade correlated with airway severity in HFM. Patients do not appear to outgrow their CL grade, as previously hypothesized, suggesting that KP III patients remain at increased risk for airway insufficiency into the teen years. Given the potential significant morbidity associated with airway compromise, proper identification and preparation for challenging airway is a critical part of caring for patients with HFM.

PMID:37257130 | DOI:10.1097/PRS.0000000000010785