Category: Nevin Manimala

Neuroimage. 2023 Apr 20:120089. doi: 10.1016/j.neuroimage.2023.120089. Online ahead of print.

ABSTRACT

To embrace big-data neuroimaging, harmonizing the site effect in resting-state functional magnetic resonance imaging (R-fMRI) data fusion is a fundamental challenge. A comprehensive evaluation of potentially effective harmonization strategies, particularly with specifically collected data, has been scarce, especially for R-fMRI metrics. Here, we comprehensively assess harmonization strategies from multiple perspectives, including tests on residual site effect, individual identification, test-retest reliability, and replicability of group-level statistical results, on widely used R-fMRI metrics across various datasets, including data obtained from participants with repetitive measures at different scanners. For individual identifiability (i.e., whether the same subject could be identified across R-fMRI data scanned across different sites), we found that, while most methods decreased site effects, the Subsampling Maximum-mean-distance based distribution shift correction Algorithm (SMA) and parametric unadjusted CovBat outperformed linear regression models, linear mixed models, ComBat series and invariant conditional variational auto-encoder in clustering accuracy. Test-retest reliability was better for SMA and parametric adjusted CovBat than unadjusted ComBat series and parametric unadjusted CovBat in the number of overlapped voxels. At the same time, SMA was superior to the latter in replicability in terms of the Dice coefficient and the scale of brain areas showing sex differences reproducibly observed across datasets. Furthermore, SMA better detected reproducible sex differences of ALFF under the site-sex confounded situation. Moreover, we designed experiments to identify the best target site features to optimize SMA identifiability, test-retest reliability, and stability. We noted both sample size and distribution of the target site matter and introduced a heuristic formula for selecting the target site. In addition to providing practical guidelines, this work can inform continuing improvements and innovations in harmonizing methodologies for big R-fMRI data.

PMID:37086875 | DOI:10.1016/j.neuroimage.2023.120089

Int J Infect Dis. 2023 Apr 20:S1201-9712(23)00531-3. doi: 10.1016/j.ijid.2023.04.400. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this study was to determine whether an observed peri-papillary ischemia is a potential biomarker of tick-borne infection (TI).

METHODS: An experimental design analyzing the optic nerve to demonstrate peri-papillary ischemia and vessel density changes through ocular coherence tomography with angiography (OCT-A) in subjects with TI. Glaucoma was ruled out and the study engaged subjects in the age range between 8-40 years. All subjects in the experimental group experienced visual symptoms. Subjects in the control group were asymptomatic and not previously diagnosed with TI. The OCT-A scanned vessel density of peri-capillary plexus surrounding the optic nerves, the images were rated by percentage of vessel density. A two-tail t-test analysis was used to analyze the results.

RESULTS: The t-test for each measure comparing the difference-of-differences to a zero change at baseline returned statistically significant results demonstrating reduced vessel density for the subjects in the experimental group (p < .0001; 95% CI [32.37409-43.50091]).

CONCLUSION: The appearance of peri-papillary ischemia in persons below the age of 50 represents a potential screening biomarker of TI. Primary care physicians, ophthalmologists and optometrists who have patients presenting sudden onset of visual symptoms in addition to the appearance of peri-papillary ischemia should be tested to rule out a tick-borne infection.

PMID:37086868 | DOI:10.1016/j.ijid.2023.04.400

Transl Behav Med. 2023 Apr 22:ibad016. doi: 10.1093/tbm/ibad016. Online ahead of print.

ABSTRACT

Despite effective treatment options, people who experience mental health conditions often do not receive needed care. E-mental health, for instance the use of mobile apps, is emerging as a way to increase access to and extend care. However, little formal training is available to increase the digital literacy level among behavioral healthcare providers (BHPs), seeking to employ such technology. The purpose of this study was to explore the acceptability and usability of an adapted in-person Digital Navigation Training (DNT) curriculum into e-Learning modules focused on the integrated environment for BHPs. BHP confidence to serve as digital navigators was also explored. E-Learning modules were adapted from an existing in-person DNT. A purposeful sampling strategy was used to recruit BHPs (n = 8) to complete the modules. Acceptability, usability, and confidence were assessed via survey and semi-structured interviews. Descriptive statistics were calculated for survey data and qualitative data were analyzed using a directed content analysis approach. BHPs who completed the training (n = 8) felt the modules were usable, enjoyed the structure, and felt the amount of time to complete the modules was acceptable. All participants thought the structure of the training worked well and enjoyed learning new information. While participants’ confidence in their digital navigation skills increased, they desired more information and/or experience with screening apps prior to increasing their use of apps within their care. E-Learning modules were an acceptable method of educating BHPs with digital navigation skills. Future research is needed to explore incentives needed for training along with if participating in these modules can increase use of quality mobile apps to augment care within BHP treatment plans.

PMID:37086443 | DOI:10.1093/tbm/ibad016

Neurourol Urodyn. 2023 Apr 22. doi: 10.1002/nau.25191. Online ahead of print.

ABSTRACT

OBJECTIVES: To compare treatment response in women who did and did not develop a urinary tract infection (UTI) within 14 days after intravesical onabotulinumtoxinA injections for treatment of refractory urgency urinary incontinence (UUI).

METHODS: This is a secondary analysis of women who received Onabotulinumtoxin A in the Refractory Overactive Bladder: Sacral Neuromodulation vs Botulinum Toxin Assessment (ROSETTA) Trial. Participants were grouped by presence or absence of UTI within 14 days of injection. UTI was defined as symptomatic with positive urine culture per the primary ROSETTA protocol. Our primary outcome was change from baseline in mean number of UUI episodes based on monthly 3-day bladder diaries averaged over 6 months. We performed t tests and chi-square/Fisher’s exact for continuous and categorical variables. A p value of <0.05 was considered statistically significant.

RESULTS: Of 187 participants in the onabotulinumtoxinA arm, 10 (5.3%) experienced UTI within 14 days of injection, and 177 (94.7%) did not. At baseline, groups did not differ in demographics, mean UUI episodes per day (no UTI [5.37 ± 2.65] vs. UTI [6.40 ± 3.02], p = 0.24), or other diary parameters. For our primary outcome, groups did not differ in the change in mean daily UUI episodes at 1 month (no UTI [-4.29 ± 2.75] vs. UTI [-3.74 ± 2.01]; mean difference [95% confidence interval, CI] -0.55 [-2.39 to 1.28], p: 0.55) or 6 months (no UTI [-3.63 ± 2.89] vs. UTI [-2.15 ± 3.18]; mean difference [95% CI] -1.48 [-3.44 to 0.48], p: 0.14).

CONCLUSIONS: UTI within 14 days after intravesical injection of onabotulinumtoxinA for refractory UUI was not significantly associated with inferior treatment response at 1 or 6 months.

PMID:37086398 | DOI:10.1002/nau.25191

J Robot Surg. 2023 Apr 22. doi: 10.1007/s11701-023-01593-z. Online ahead of print.

ABSTRACT

This study aimed to comparatively evaluate postoperative pain, anxiety, and sleep quality in patients after robotic-assisted and manual total knee replacement surgery. Patients who underwent either robotic or manual total knee replacement (TKR) surgery were analyzed in this cross-sectional observational study. Volunteers who were conscious, mentally healthy, without primary sleep disorders, without chronic uncontrolled diseases, 18 years of age or older, able to understand verbal warnings, and who agreed to participate in the study after being informed about the purpose of the study were included in the study. A total of 80 patients who underwent robotic-assisted TKR and 87 patients who underwent manual TKR were participated in the study. Data were collected using the “Patient Description Form” Visual Analog Scale, Richards-Campbell Sleep Scale, and State Anxiety Scale. All patients were operated on by the same physicians and received standard perioperative care. In the study, a statistically significant difference was found between the education level of the patients and the type of surgery (p = 0.007). According to the average scores, it was observed that the patients in the robotic group had higher pain levels, better sleep quality, and higher anxiety levels compared to the manual group. There was a significant correlation between the level of pain felt on the 1st and 2nd day (p = < 0.001) and state anxiety levels with gender (p = 0.010) in the robotic group. For the robotic group, pain on day 2 was mostly affected by pain on day 1 and state anxiety. For the manual group, pain on day 2 was mostly affected by pain on day 1. According to our results, patients who underwent robotic-assisted TKR had higher pain levels, better sleep quality, and higher anxiety levels than patients who underwent manual TKR.

PMID:37086363 | DOI:10.1007/s11701-023-01593-z

Support Care Cancer. 2023 Apr 22;31(5):292. doi: 10.1007/s00520-023-07740-4.

ABSTRACT

PURPOSE: All patients living with cancer, including those with metastatic cancer, are encouraged to be physically active. This paper examines the secondary endpoints of an aerobic exercise intervention for men with metastatic prostate cancer.

METHODS: ExPeCT (Exercise, Prostate Cancer and Circulating Tumour Cells), was a multi-centre randomised control trial with a 6-month aerobic exercise intervention arm or a standard care control arm. Exercise adherence data was collected via heart rate monitors. Quality of life (FACT-P) and physical activity (self-administered questionnaire) assessments were completed at baseline, at 3 months and at 6 months.

RESULTS: A total of 61 patients were included (69.4 ± 7.3 yr, body mass index 29.2 ± 5.8 kg/m²). The median time since diagnosis was 34 months (IQR 7-54). A total of 35 (55%) of participants had > 1 region affected by metastatic disease. No adverse events were reported by participants. There was no effect of exercise on quality of life (Cohen’s d = – 0.082). Overall adherence to the supervised sessions was 83% (329 out of 396 possible sessions attended by participants). Overall adherence to the non-supervised home exercise sessions was 72% (months 1-3) and 67% (months 3-6). Modelling results for overall physical activity scores showed no significant main effect for the group (p-value = 0.25) or for time (p-value = 0.24).

CONCLUSION: In a group of patients with a high burden of metastatic prostate cancer, a 6-month aerobic exercise intervention did not lead to change in quality of life. Further exercise studies examining the role of exercise for people living with metastatic prostate cancer are needed.

TRIAL REGISTRATION: The trial was registered at clinicaltrials.gov (NCT02453139) on May 25th 2015.

PMID:37086362 | DOI:10.1007/s00520-023-07740-4

Prev Sci. 2023 Apr 22. doi: 10.1007/s11121-023-01521-5. Online ahead of print.

ABSTRACT

Transgender and gender diverse (TGD) youth experience significant risk for negative health outcomes, yet few studies exist that address TGD youth’s experiences of health care. This paper explores the equitable access and utilization of health care in a sample of TGD youth of diverse gender and racial/ethnic identities. Data for this analysis are from the TGD subsample (n = 1415) of the 2018 Survey of Today’s Adolescent Relationships and Transitions (START) Project. We assessed five health care experiences: being insured, having a current health care provider, being out to one’s provider, believing your provider was knowledgeable about transgender issues, and barriers to accessing care due to gender identity/expression. We examined the proportion of TGD youth who reported each of these outcomes and within-group differences by gender identity and race/ethnicity using descriptive statistics, logistic regression, and predicted probabilities. When differences were examined by gender identity, barriers to equitable care were consistently more present among transgender females than youth of other gender identities. There were few significant differences by race/ethnicity; however, dual referent models demonstrated barriers to equitable care were particularly evident among Black and Hispanic transgender women. We discuss these findings through the lens of intersectionality and highlight the importance of research and intervention work focused on reducing barriers to equitable care for TGD youth.

PMID:37086334 | DOI:10.1007/s11121-023-01521-5

Clin Rheumatol. 2023 Apr 22. doi: 10.1007/s10067-023-06558-z. Online ahead of print.

ABSTRACT

This study aims to determine the number and type of incidental findings detected on positron emission tomography (PET)/CT in a cohort of patients with large vessel vasculitis (LVV). Reports from PET/CT studies along with the medical charts of a cohort of patients with LVV from a Rheumatology clinic in Edmonton, Alberta, Canada, were retrospectively reviewed. Incidental findings from PET/CT, along with follow-up studies and their diagnosis were documented. The data was analyzed with descriptive statistics. The disease activity of 40 patients, with an average age of 65.8 years, was investigated using PET/CT. A statistically significant increase in incidental findings with age was observed. A total of 61 incidental findings were found in 26 (65%) patients. Of these findings, 25 were in the abdomen and pelvis. The most common incidental finding was lymphadenopathy. Follow-up investigations of incidental findings lead to 5 clinically significant findings including metastatic adenocarcinoma, Mycobacterium avium infection, papillary thyroid carcinoma, pheochromocytoma, and stroke. PET/CT is a reliable tool for determining disease activity in LVV patients and the implications of incidental findings need to be discussed with patients by the ordering care provider. This study demonstrates that incidental findings on PET/CT scan are common and increase with age in patients with LVV. A significant number of patients required further investigation for incidental findings. Key Points • Incidental findings on PET/CT scan are common in our patient population with LVV. • Frequency of incidental findings in our patient population with LVV increased with age. • Findings from this study can be used by ordering providers to have an informed conversation with their patient about the frequency of incidental findings on PET/CT scans.

PMID:37086310 | DOI:10.1007/s10067-023-06558-z

Eur J Clin Microbiol Infect Dis. 2023 Apr 22. doi: 10.1007/s10096-023-04594-w. Online ahead of print.

ABSTRACT

The aim of this study is to evaluate the chlorhexidine gluconate (CHG) susceptibility in both planktonic cells and biofilm of 32 Gram-negative (Gn) and 6 Gram-positive (Gp) isolates by minimal inhibitory concentration (2-256 μg/mL for Gn and 2-32 μg/mL for Gp), minimal bactericidal concentration (4-256 μg/mL for Gn and 2-32 μg/mL for Gp) in planktonic cells, and minimal biofilm elimination concentration (128 ≥ 16,384 μg/mL in Gn and 32 ≥ 16,384 μg/mL in Gp) in biofilm environment. Our study showed that Gn isolates have higher minimal concentrations than Gp and bacteria in biofilms are more tolerant than planktonic ones. No correlation between MBC or MBEC and biofilm formation was statistically confirmed. The Eagle effect, previously described for antimicrobials and antifungals, was evidenced in this work for CHG, an antiseptic. Besides that, the phenomenon was described in 23/38 isolates (60.5%), raising minimal concentration up to ≥ 16,384 μg/mL. Our study showed that clinical isolates have a high ability to form biofilm allowing them to tolerate CHG concentrations as high as the ones used in clinical practice. Therefore, attention should be given to the occurrence of this phenomenon to avoid false susceptibility results.

PMID:37086303 | DOI:10.1007/s10096-023-04594-w

J Math Biol. 2023 Apr 22;86(5):79. doi: 10.1007/s00285-023-01913-9.

ABSTRACT

We analyse a generalisation of the stochastic gene expression model studied recently in Fromion et al. (SIAM J Appl Math 73:195-211, 2013) and Robert (Probab Surv 16:277-332, 2019) that keeps track of the production of both mRNA and protein molecules, using techniques from the theory of point processes, as well as ideas from the theory of matrix-analytic methods. Here, both the activity of a gene and the creation of mRNA are modelled with an arbitrary Markovian Arrival Process governed by finitely many phases, and each mRNA molecule during its lifetime gives rise to protein molecules in accordance with a Poisson process. This modification is important, as Markovian Arrival Processes can be used to approximate many types of point processes on the nonnegative real line, meaning this framework allows us to further relax our assumptions on the overall process of transcription.

PMID:37086292 | DOI:10.1007/s00285-023-01913-9