Category: Nevin Manimala

J Oral Maxillofac Surg. 2023 May 2:S0278-2391(23)00393-2. doi: 10.1016/j.joms.2023.04.013. Online ahead of print.

ABSTRACT

PURPOSE: Zygomatic fractures involve complex anatomical structures of the mid-face and the diagnosis can be challenging and labor-consuming. This research is aimed to evaluate the performance of an automatic algorithm for the detection of zygomatic fractures based on convolutional neural network (CNN) on spiral computed tomography (CT).

MATERIALS AND METHODS: We designed a cross-sectional retrospective diagnostic trial study. Clinical records and CT scans of patients with zygomatic fractures were reviewed. The sample consisted of two types of patients with different zygomatic fractures statuses (positive or negative) in Peking University School of Stomatology from 2013 to 2019. All CT samples were randomly divided into three groups at a ratio of 6:2:2 as training set, validation set, and test set, respectively. All CT scans were viewed and annotated by three experienced maxillofacial surgeons, serving as the gold standard. The algorithm consisted of two modules as follows: (1) segmentation of the zygomatic region of CT based on U-Net, a type of CNN model; (2) detection of fractures based on Deep Residual Network 34(ResNet34). The region segmentation model was used first to detect and extract the zygomatic region, then the detection model was used to detect the fracture status. The Dice coefficient was used to evaluate the performance of the segmentation algorithm. The sensitivity and specificity were used to assess the performance of the detection model. The covariates included age, gender, duration of injury, and the etiology of fractures.

RESULTS: A total of 379 patients with an average age of 35.43 ± 12.74 years were included in the study. There were 203 nonfracture patients and 176 fracture patients with 220 sites of zygomatic fractures (44 patients underwent bilateral fractures). The Dice coefficientof zygomatic region detection model and gold standard verified by manual labeling were 0.9337 (coronal plane) and 0.9269 (sagittal plane), respectively. The sensitivity and specificity of the fracture detection model were 100% (p＞.05).

CONCLUSION: The performance of the algorithm based on CNNs was not statistically different from the gold standard (manual diagnosis) for zygomatic fracture detection in order for the algorithm to be applied clinically.

PMID:37217163 | DOI:10.1016/j.joms.2023.04.013

Gene. 2023 May 20:147501. doi: 10.1016/j.gene.2023.147501. Online ahead of print.

ABSTRACT

Familial hypercholesterolemia (FH) is a monogenic disease characterized by high plasma low-density lipoprotein cholesterol (LDL-c) levels and increased risk of premature atherosclerotic cardiovascular disease. Mutations in FH-related genes account for 40% of FH cases worldwide. In this study, we aimed to assess the pathogenic variants in FH-related genes in the Brazilian FH cohort FHBGEP using exon-targeted gene sequencing (ETGS) strategy. FH patients (n=210) were enrolled at five clinical sites and peripheral blood samples were obtained for laboratory testing and genomic DNA extraction. ETGS was performed using MiSeq platform (Illumina). To identify deleterious variants in LDLR, APOB, PCSK9, and LDLRAP1, the long-reads were subjected to Burrows-Wheeler Aligner (BWA) for alignment and mapping, followed by variant calling using Genome Analysis Toolkit (GATK) and ANNOVAR for variant annotation. The variants were further filtered using in-house custom scripts and classified according to the American College Medical Genetics and Genomics (ACMG) guidelines. A total of 174 variants were identified including 85 missense, 3 stop-gain, 9 splice-site, 6 InDel, and 71 in regulatory regions (3’UTR and 5’UTR). Fifty-two patients (24.7%) had 30 known pathogenic or likely pathogenic variants in FH-related genes according to the American College Medical and Genetics and Genomics guidelines. Fifty-three known variants were classified as benign, or likely benign and 87 known variants have shown uncertain significance. Four novel variants were discovered and classified as such due to their absence in existing databases. In conclusion, ETGS and in silico prediction studies are useful tools for screening deleterious variants and identification of novel variants in FH-related genes, they also contribute to the molecular diagnosis in the FHBGEP cohort.

PMID:37217153 | DOI:10.1016/j.gene.2023.147501

Ophthalmol Retina. 2023 May 20:S2468-6530(23)00223-3. doi: 10.1016/j.oret.2023.05.012. Online ahead of print.

ABSTRACT

PURPOSE: To assess the risk of retinal displacement following scleral buckle (SB) versus pars plana vitrectomy with scleral buckle (PPV-SB).

DESIGN: Multi-center prospective non-randomized clinical trial.

METHODS: The study took place at VitreoRetinal Surgery in Minneapolis, USA; Sankara Nethralaya in Chennai, India and St. Michael’s Hospital in Toronto, Canada from July 2019 to February 2022. Patients who underwent successful SB or PPV-SB for fovea-involving rhegmatogenous retinal detachment (RRD) with gradable post-operative fundus autofluorescence (FAF) imaging were included in the final analysis. Two masked graders assessed FAF images 3-months post-operatively. Metamorphopsia and aniseikonia were assessed with MCHARTs and the New Aniseikonia Test, respectively. The primary outcome was the proportion of patients with retinal displacement detected with retinal vessel printings (RVPs) on FAF in SB vs PPV-SB.

RESULTS: Ninety-one eyes were included in this study of which 46.2%(42/91) had SB and 53.8%(49/91) underwent PPV-SB. At 3-months post-operatively, 16.7%(7/42) in the SB group and 38.8%(19/49) in the PPV-SB group had evidence of retinal displacement (difference=22.1%;odds ratio=3.2,95%CI=1.2-8.6;p=0.02) on FAF. The statistical significance of this association increased after adjustment for extent of retinal detachment, baseline logMAR, lens status, and gender in a multivariate regression analysis (p=0.01). Retinal displacement was detected in 22.5%(6/27) of patients in the SB group with external subretinal fluid drainage and 6.7%(1/15) of patients without external drainage (difference=15.8%,odds ratio=4.0,95%CI=0.4-36.9;p=0.19). Mean vertical metamorphopsia, horizontal metamorphopsia and aniseikonia were similar between patients in the SB and PPV-SB groups. There was a trend to worse horizontal metamorphopsia in patients with retinal displacement vs those without retinal displacement (p=0.067).

CONCLUSIONS: SB, is associated with less retinal displacement compared to PPV-SB, indicating that traditional PPV techniques cause retinal displacement. There is a trend towards increased risk of retinal displacement in SB eyes that underwent external drainage compared to SB eyes without drainage which is consistent with our understanding, that the iatrogenic movement of subretinal fluid, such as that which occurs intraoperatively during external drainage with SB, may induce retinal stretch and displacement if the retina is then fixed in the stretched position. There was a trend to worse horizontal metamorphopsia at 3-months in patients with retinal displacement.

PMID:37217137 | DOI:10.1016/j.oret.2023.05.012

Rev Esp Cardiol (Engl Ed). 2023 May 20:S1885-5857(23)00139-1. doi: 10.1016/j.rec.2023.05.002. Online ahead of print.

ABSTRACT

INTRODUCTION AND OBJECTIVES: We aimed to describe the clinical outcomes of the use of the CentriMag acute circulatory support system as a bridge to emergency heart transplantation (HTx).

METHODS: We conducted a descriptive analysis of the clinical outcomes of consecutive HTx candidates included in a multicenter retrospective registry who were treated with the CentriMag device, configured either for left ventricular support (LVS) or biventricular support (BVS). All patients were listed for high-priority HTx. The study assessed the period 2010 to 2020 and involved 16 transplant centers around Spain. We excluded patients treated with isolated right ventricular support or venoarterial extracorporeal membrane oxygenation without LVS. The primary endpoint was 1-year post-HTx survival.

RESULTS: The study population comprised 213 emergency HTx candidates bridged on CentriMag LVS and 145 on CentriMag BVS. Overall, 303 (84.6%) patients received a transplant and 53 (14.8%) died without having an organ donor during the index hospitalization. Median time on the device was 15 days, with 66 (18.6%) patients being supported for > 30 days. One-year posttransplant survival was 77.6%. Univariable and multivariable analyses showed no statistically significant differences in pre- or post-HTx survival in patients managed with BVS vs LVS. Patients managed with BVS had higher rates of bleeding, need for transfusion, hemolysis and renal failure than patients managed with LVS, while the latter group showed a higher incidence of ischemic stroke.

CONCLUSIONS: In a setting of candidate prioritization with short waiting list times, bridging to HTx with the CentriMag system was feasible and resulted in acceptable on-support and posttransplant outcomes.

PMID:37217134 | DOI:10.1016/j.rec.2023.05.002

Environ Res. 2023 May 20:116209. doi: 10.1016/j.envres.2023.116209. Online ahead of print.

ABSTRACT

Bemisia tabaci Gennadius, also renowned as the silver leaf whitefly, is among the most damaging polyphagous insect pests in many commercially important crops and commodities. A set of field experiments were conducted for three consecutive years i.e., 2018-2020, to investigate the role of variations in rainfall, temperature, and relative humidity on the abundance of B. tabaci in okra (Abelmoschus esculentus L. Moench). In the first experiment, the variety Arka Anamika was cultivated twice a year to analyse the incidence of B. tabaci concerning the prevailing weather factors and the overall pooled incidence recorded during the dry and wet season was 1.34 ± 0.51 to 20.03 ± 1.42 and 2.26 ± 1.08 to 18.3 ± 1.96, respectively. Similarly, it was observed that the highest number of B. tabaci catch (19.51 ± 1.64 whiteflies/3 leaves) was recorded in morning hours between 08:31 to 09:30 a.m. The Yellow Vein Mosaic Disease (YVMD) is a devastating disease of okra caused by begomovirus, for which B. tabaci acts as a vector. In another experiment, screening was conducted to check the relative susceptibility of three different varieties viz., Arka Anamika, Pusa Sawani, and Parbhani Kranti against B. tabaci (incidence) and YVMD ((Percent Disease Incidence (PDI), Disease Severity Index (DSI), and Area Under the Disease Progress Curve (AUDPC)). The recorded data was normalized by standard transformation and subjected to ANOVA for population dynamics and PDI. Pearson’s rank correlation matrix and Principal Component Analysis (PCA) have been used to relate the influences of various weather conditions on distribution and abundance. SPSS and R software were used to create the regression model for predicting the population of B. tabaci. Late sown Pusa Sawani evolved as a highly susceptible variety in terms of B. tabaci (24.83 ± 6.79 adults/3leaves; mean ± SE; N = 10) as well as YVMD i.e., PDI (38.00 ± 4.95 infected plants/50plants), DSI (71.6-96.4% at 30 DAS) and AUDPC (mean β-value = 0.76; R² = 0.96) while early sown Parbhani Kranti least susceptible to both. However, the variety Arka Anamika was observed as moderately susceptible to B. tabaci and its resultant disease. Moreover, environmental factors were predominantly responsible for regulating the population of insect pests in the field and hence its productivity like rainfall and relative humidity were negative while the temperature was positively correlated with B. tabaci (incidence) and YVMD (AUDPC). The findings are helpful for the farmers to choose need-based IPM strategies than timing-based, which would fit perfectly with the present agro-ecosystems in all ways.

PMID:37217129 | DOI:10.1016/j.envres.2023.116209

Environ Res. 2023 May 20:116206. doi: 10.1016/j.envres.2023.116206. Online ahead of print.

ABSTRACT

Air pollution has been linked to adverse neonatal outcomes, mainly in the case of prolonged exposures. This study focuses on the short-term effects on maternal health. We conducted a retrospective ecological time-series study in the Madrid Region covering the period 2013-2018. The independent variables were mean daily concentrations of tropospheric ozone (O₃), particulate matter (PM₁₀/PM_2.5) and nitrogen dioxide (NO₂), as well as noise levels. The dependent variables were daily emergency hospital admissions due to complications in pregnancy, childbirth and the puerperium. Poisson generalised linear regression models were fitted to quantify the relative and attributable risks, controlling for trend, seasonality, the autoregressive nature of the series, and a number of meteorological factors. There were 318 069 emergency hospital admissions due to obstetric complications across the 2191 days of study. Of this total: 13 164 (95%CI: 9930-16 398) admissions were attributable to exposure to O₃, the only pollutant to show a statistically significant (p < 0.05) association with admissions due to hypertensive disorders; and 10 575 (95%CI: 3573-17 566) admissions were attributable to daytime noise levels, while admissions due to hyperemesis gravidarum and vomiting were related to exposure to night noise. Other pollutants which also displayed statistically significant associations were: NO₂ concentrations, with admissions due to vomiting and preterm labour; PM₁₀ concentrations, with premature rupture of membranes: and PM_2.5 concentrations, with total complications. Exposure to a range of air pollutants, and ozone in particular, is associated with a higher number of emergency hospital admissions due to gestational complications. Hence, surveillance of environmental effects on maternal health should be intensified, and plans and strategies to minimise these should be drawn up.

PMID:37217123 | DOI:10.1016/j.envres.2023.116206

Microb Pathog. 2023 May 20:106160. doi: 10.1016/j.micpath.2023.106160. Online ahead of print.

ABSTRACT

Non-alcoholic fatty liver (NAFLD), and its complicated form, non-alcoholic steatohepatitis (NASH), have been associated with gut dysbiosis with specific signatures. Endogenous ethanol production by Klebsiella pneumoniae or yeasts has been identified as a potential physio-pathological mechanism. A species-specific association between Lactobacillus and obesity and metabolic diseases has been reported. In this study, the microbial composition of ten cases of NASH and ten controls was determined using v3v4 16S amplicon sequencing as well as quantitative PCR (qPCR). Using different statistical approaches, we found an association of Lactobacillus and Lactoccocus with NASH, and an association of Methanobrevibacter, Faecalibacterium and Romboutsia with controls. At the species level, Limosilactobacillus fermentum and Lactococcus lactis, two species producing ethanol, and Thomasclavelia ramosa, a species already associated with dysbiosis, were associated with NASH. Using qPCR, we observed a decreased frequency of Methanobrevibacter smithii and confirmed the high prevalence of L. fermentum in NASH samples (5/10), while all control samples were negative (p = 0.02). In contrast, Ligilactobacillus ruminis was associated with controls. This supports the critical importance of taxonomic resolution at the species level, notably with the recent taxonomic reclassification of the Lactobacillus genus. Our results point towards the potential instrumental role of ethanol-producing gut microbes in NASH patients, notably lactic acid bacteria, opening new avenues for prevention and treatment.

PMID:37217120 | DOI:10.1016/j.micpath.2023.106160

J Clin Epidemiol. 2023 May 20:S0895-4356(23)00124-5. doi: 10.1016/j.jclinepi.2023.05.011. Online ahead of print.

ABSTRACT

OBJECTIVES: Preliminary studies play a key role in developing large-scale interventions but may be held to higher or lower scientific standards during the peer review process because of their preliminary study status.

STUDY DESIGN: Abstracts from five published obesity prevention preliminary studies were systematically modified to generate 16 variations of each abstract. Variations differed by four factors: sample size (n=20 vs. n=150), statistical significance (P<.05 vs. P>.05), study design (single group vs. randomized two group), and preliminary study status (presence/absence of pilot language). Using an online survey, behavioral scientists were provided with a randomly selected variation of each of the five abstracts and blinded to the existence of other variations. Respondents rated each abstract on aspects of study quality.

RESULTS: Behavioral scientists (n=271, 79.7% female, median age 34 years) completed 1,355 abstract ratings. Preliminary study status was not associated with perceived study quality. Statistically significant effects were rated as more scientifically significant, rigorous, innovative, clearly written, warranted further testing, and had more meaningful results. Randomized designs were rated as more rigorous, innovative, and meaningful.

CONCLUSION: Findings suggest reviewers place a greater value on statistically significant findings and randomized control design and may overlook other important study characteristics.

PMID:37217107 | DOI:10.1016/j.jclinepi.2023.05.011

Clin Imaging. 2023 May 18;100:54-59. doi: 10.1016/j.clinimag.2023.05.006. Online ahead of print.

ABSTRACT

OBJECTIVE: The effect of iodinated contrast material (CM) temperature on injection pressures and viscosity has been well established. However, the effect of extrinsic warming of CM on allergic reactions and extravasations remains unclear. The purpose of this study is to compare the rates of allergic reactions and extravasations between warmed CM to room temperature CM.

METHODS: We conducted a comprehensive systematic search using PubMed, Embase, and Web of Science databases for all studies that assess the impact of warmed CM on adverse reactions. The primary outcomes of our study were allergic reaction and extravasation rates. We calculated weighted pooled odds ratios (OR) and 95% confidence intervals (CI) for all outcomes using the random-effects model. A P-value <0.05 was considered statistically significant. We conducted subgroup analyses based on the viscosity of the CM.

RESULTS: A total of five studies, including 307,329 CM injections (86,676 at room temperature and 220,653 warmed to 37 °C), were included in the analysis. For high viscosity CM, pre-warming was associated with significantly lower allergic reaction rates (OR: 0.59, 95% CI: 0.49-0.72, P < 0.00001). There was no significant difference in rates of extravasation for high viscosity CM (OR: 0.53, 95% CI: 0.20-1.43, P = 0.21).

DISCUSSION: Our meta-analysis suggests that warming CM to 37 °C is a safe and effective approach to reduce the risk of allergic reactions and physiologic reactions during injection of high-viscosity CM. However, there was no significant difference in extravasation rates between warmed and room temperature CM, regardless of viscosity.

PMID:37216743 | DOI:10.1016/j.clinimag.2023.05.006

Ticks Tick Borne Dis. 2023 May 20;14(5):102200. doi: 10.1016/j.ttbdis.2023.102200. Online ahead of print.

ABSTRACT

Ticks and tick-borne diseases cause significant loss in livestock production with about 80% world’s cattle at risk. The cost of chemical control is high and there is an ever-increasing tick resistance to chemical acaricides. Genetic selection as alternative long-term control strategy is constrained by laborious phenotyping using tick counts or scores. This study explored the use of host volatile semiochemicals that may be attractants or repellents to ticks as a phenotype for new tick resistance, with potential to be used as a proxy in selection programmes. Approximately 100 young cattle composed of Bos indicus and Bos taurus were artificially infested with 2,500 African blue tick, Rhipicephalus decoloratus larvae, with daily female tick (4.5 mm) counts taken from day 20 post-infestation. Volatile organic compounds were sampled from cattle before and after tick infestation by dynamic headspace collection, analysed by high-resolution gas chromatography (GC) and subjected to multivariate statistical analysis. Using 6-day repeated measure analysis, three pre-infestation GC peaks (BI938 – unknown, BI966 – 6-methyl-5-hepten-2-one and BI995 – hexyl acetate) and one post-infestation GC peak (AI933 – benzaldehyde / (E)-2-heptenal) were associated with tick resistance (P < 0.01 and P < 0.05 respectively). The high correlation coefficients (r = 0.66) between repeated records with all volatile compounds support the potential predictive value for volatile compounds in selective breeding programmes for tick resistance in cattle.

PMID:37216729 | DOI:10.1016/j.ttbdis.2023.102200