Category: Nevin Manimala

Sci Rep. 2023 Apr 16;13(1):6190. doi: 10.1038/s41598-023-33269-x.

ABSTRACT

Laparoscopic (LPD) and robotic pancreaticoduodenectomy (RPD) are both challenging procedures. The feasibility and safety of simultaneously developing LPD and RPD remain unreported. We retrospectively reviewed the data of patients undergoing LPD or RPD between 2014 and 2021. A total of 114 patients underwent minimally invasive pancreaticoduodenectomy (MIPD): 39 LPDs and 75 RPDs. The learning process of LPD and RPD were similar. The cutoff points of the learning curve were LPD, 13th patient (the 27th patient of MIPD), and RPD, 18th patient (the 31st patient of MIPD) according the cumulative sum analysis of operative time. A decrease in the operative time was associated with the case sequence (p < 0.001) but not with the surgical approach (p = 0.36). The overall surgical outcomes were comparable between both the LPD and RPD groups. When evaluating the learning curve impact on MIPD, LPD had higher major complication (≧ Clavien-Dindo grade III), bile leak and wound infection rates in the pre-learning curve phase than those in the after-learning curve phase, while RPD had similar surgical outcomes between two phases. Simultaneous development of LPD and RPD is feasible and safe for experienced surgeons, with similar learning process and comparable surgical outcomes.

PMID:37062774 | DOI:10.1038/s41598-023-33269-x

Eur Radiol. 2023 Apr 17. doi: 10.1007/s00330-023-09629-6. Online ahead of print.

ABSTRACT

OBJECTIVES: To evaluate the feasibility of 0.2-mm isotropic lenticulostriate arteries (LSAs) imaging using compressed sensing time-of-flight (CS TOF) at around 10 min on 7T, and compare the delineation and characterization of LSAs using conventional TOF and CS TOF.

METHODS: Thirty healthy volunteers were examined with CS TOF and conventional TOF at 7T for around 10 min each. CS TOF was optimized to achieve 0.2-mm isotropic LSA imaging. The numbers of LSA stems and branches were counted and compared on a vascular skeleton. The length and distance were measured and compared on the most prominent branch in each hemisphere. Another patient with intracranial artery stenosis was studied to compare LSA delineation in CS TOF and digital subtraction angiography (DSA).

RESULTS: The number of stems visualized with CS TOF was significantly higher than with conventional TOF in both left (p = 0.002, ICC = 0.884) and right (p < 0.001, ICC = 0.938) hemispheres. The number of branches visualized by conventional TOF was significantly lower than that by CS TOF in both left (p < 0.001, ICC = 0.893) and right (p < 0.001, ICC = 0.896) hemispheres. The lengths were statistically higher in CS TOF than in conventional TOF (left: p < 0.001, ICC = 0.868; right: p < 0.001, ICC = 0.876).

CONCLUSIONS: The high-resolution CS TOF improves the delineation and characterization of LSAs over conventional TOF. High-resolution LSA imaging using CS TOF can be a promising tool for clinical research and applications in patients with neurologic diseases.

KEY POINTS: • 0.2-mm isotropic LSA imaging for around 10 min using CS TOF at 7T is feasible. • More stems and branches of LSAs with longer lengths can be delineated with CS TOF than with conventional TOF at the same scan time. • High-resolution CS TOF can be a promising tool for research and applications on LSA.

PMID:37062772 | DOI:10.1007/s00330-023-09629-6

Pediatr Radiol. 2023 Apr 17. doi: 10.1007/s00247-023-05637-2. Online ahead of print.

ABSTRACT

BACKGROUND: Intracranial pressure (ICP) monitoring in children currently requires invasive techniques. Subharmonic aided pressure estimation (SHAPE) uses contrast-enhanced ultrasound (CEUS) to measure intravascular and interstitial pressure, but utility in ICP measurements has yet to be explored.

OBJECTIVE: The objective of this study was to investigate SHAPE as a novel tool for noninvasive ICP measurements in fetal lambs.

MATERIALS AND METHODS: Eighteen fetal lambs at 107-139 days gestational age (term = 145 days) underwent subdural ICP catheter placement. The brain was imaged in the coronal plane in CEUS mode optimized for SHAPE, while infusing an US contrast agent into the fetal circulation. After SHAPE calibration, saline was infused via the subdural catheter to increase ICP. Five-second SHAPE cine clips were obtained at various ICPs. Subharmonic intensity values of the whole brain and thalami were correlated with ICP values using mixed effects linear regression analyses and the strength of the relationship was evaluated by Spearman’s rank-order correlation.

RESULTS: Forty-nine experiments produced 723 datapoints, including SHAPE intensity values and mean ICP measurements. There was a statistically significant inverse relationship between SHAPE intensity values and ICP measurements in the whole brain and thalami (median rho value – 0.58 and – 0.56, respectively).

CONCLUSION: SHAPE intensity values of the brain demonstrate an inverse and statistically significant correlation with in vivo ICP measurements in an animal model.

PMID:37062765 | DOI:10.1007/s00247-023-05637-2

Psychogeriatrics. 2023 Apr 16. doi: 10.1111/psyg.12965. Online ahead of print.

ABSTRACT

BACKGROUND: This study aimed to determine the effect of rumination and elder abuse levels on successful aging in elderly individuals.

METHODS: This descriptive-correlational study was conducted with older individuals (n = 297) in Ağrı, Turkey, between October 2021 and May 2022. SPSS-22 and R v.4.1.3 were used in the study. Analysis was done with machine learning and artificial neural networks.

RESULTS: In the study, the mean age of the older individuals was 67.49 ± 3.04. Statistical estimates showed the regression model to be significant and usable, F(2,294) = 116.659, P = 0.001. Elder abuse and ruminative thought levels together explained 43.9% of the total variance (R² = 0.439) of successful aging. The regression model indicated that increases in both the elder abuse level (t = -3.672, P < 0.001) and the ruminative thought level (t = -12.771, P < 0.001) of participants caused a statistically significant decrease in the successful aging level. The combined elder abuse and ruminative thought levels had a greater effect on successful aging (Model 1: F = 45.321, Model 2: F = 116.659, R² Change = 0.309). The R² value of the Random Forest regression model was 0.529, showing that the independent variables could explain 52.92% of the variation in the dependent variable. According to the SHapley Additive exPlanation values, which show the contribution or importance of each variable in the estimation of the model, it was determined that the most important variables for estimating the Successful Aging Scale variable were ruminative thought style and elder abuse screening.

CONCLUSIONS: Our study indicates that a decrease in the levels of rumination and elder abuse could lead to improvement in successful aging. Longitudinal studies on successful aging in older individuals are recommended.

PMID:37062761 | DOI:10.1111/psyg.12965

J Neurotrauma. 2023 Apr 12. doi: 10.1089/neu.2022.0221. Online ahead of print.

ABSTRACT

Prognostic prediction of traumatic brain injury (TBI) in patients is crucial in clinical decision and health care policy making. This study aimed to develop and validate prediction models for in-hospital mortality after severe traumatic brain injury (sTBI). We developed and validated logistic regression (LR), LASSO regression, and machine learning (ML) algorithms including support vector machines (SVM) and XGBoost models. Fifty-four candidate predictors were included. Model performance was expressed in terms of discrimination (C-statistic) and calibration (intercept and slope). For model development, 2804 patients with sTBI in the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) China Registry study were included. External validation was performed in 1113 patients with sTBI in the CENTER-TBI European Registry study. XGBoost achieved high discrimination in mortality prediction, and it outperformed logistic and LASSO regression. The XGBoost model established in this study also outperformed prediction models currently available, including the International Mission for Prognosis and Analysis of Clinical Trials (IMPACT) core and International Mission for Prognosis and Analysis of Clinical Trials (CRASH) basic models. When including 54 variables, XGBoost and SVM reached C-statistics of 0.87 (95% confidence interval [CI]: 0.81-0.92) and 0.85 (95% CI: 0.79-0.90) at internal validation, and 0.88 (95% CI: 0.87-0.88) and 0.86 (95% CI: 0.85-0.87) at external validation, respectively. A simplified version of XGBoost and SVM using 26 variables selected by recursive feature elimination (RFE) reached C-statistics of 0.87 (95% CI: 0.82-0.92) and 0.86 (95% CI: 0.80-0.91) at internal validation, and 0.87 (95% CI: 0.87-0.88) and 0.87 (95% CI: 0.86-0.87) at external validation, respectively. However, when the number of variables included decreased, the difference between ML and LR diminished. All the prediction models can be accessed via a web-based calculator. Glasgow Coma Scale (GCS) score, age, pupillary light reflex, Injury Severity Score (ISS) for brain region, and the presence of acute subdural hematoma were the five strongest predictors for mortality prediction. The study showed that ML techniques such as XGBoost may capture information hidden in demographic and clinical predictors of patients with sTBI and yield more precise predictions compared with LR approaches.

PMID:37062757 | DOI:10.1089/neu.2022.0221

Biol Rev Camb Philos Soc. 2023 Apr 16. doi: 10.1111/brv.12961. Online ahead of print.

ABSTRACT

Policy makers require high-level summaries of biodiversity change. However, deriving such summaries from raw biodiversity data is a complex process involving several intermediary stages. In this paper, we describe an operational workflow for generating annual estimates of species occupancy at national scales from raw species occurrence data, which can be used to construct a range of policy-relevant biodiversity indicators. We describe the workflow in detail: from data acquisition, data assessment and data manipulation, through modelling, model evaluation, application and dissemination. At each stage, we draw on our experience developing and applying the workflow for almost a decade to outline the challenges that analysts might face. These challenges span many areas of ecology, taxonomy, data science, computing and statistics. In our case, the principal output of the workflow is annual estimates of occupancy, with measures of uncertainty, for over 5000 species in each of several defined ‘regions’ (e.g. countries, protected areas, etc.) of the UK from 1970 to 2019. This data product corresponds closely to the notion of a species distribution Essential Biodiversity Variable (EBV). Throughout the paper, we highlight methodologies that might not be applicable outside of the UK and suggest alternatives. We also highlight areas where the workflow can be improved; in particular, methods are needed to mitigate and communicate the risk of bias arising from the lack of representativeness that is typical of biodiversity data. Finally, we revisit the ‘ideal’ and ‘minimal’ criteria for species distribution EBVs laid out in previous contributions and pose some outstanding questions that should be addressed as a matter of priority. Going forward, we hope that this paper acts as a template for research groups around the world seeking to develop similar data products.

PMID:37062709 | DOI:10.1111/brv.12961

Wei Sheng Yan Jiu. 2023 Mar;52(2):292-299. doi: 10.19813/j.cnki.weishengyanjiu.2023.02.019.

ABSTRACT

OBJECTIVE: To conduct a Meta-analysis of the effects of whole grains on insulin resistance in overweight and obese adults in randomize controlled trials.

METHODS: Data were retrieved from PubMed, EMBASE, MEDLINE, Cochrane Library, CBM, CNKI and other databases from the database establishment to August 9, 2021. Randomize controlled trials of the effects of whole grains on insulin resistance in overweight and obese adults were screened out. Data extraction and quality evaluation were conducted for the literatures meeting the inclusion criteria. The Meta-analysis was conducted using R4.1.2 software.

RESULTS: A total of 10 randomized controlled trials were included. Among the overweight and obese adults, the whole grains intake decreased their fasting plasma glucose(FPG)(MD=-0.08, 95%CI-0.12, -0.04), homeostasis model assessment of insulin resistance(HOMA-IR)(MD=-0.37, 95%CI-0.60, -0.14) and quantitative insulin sensitivity index(QUICKI)(MD=0.006, 95%CI 0.005, 0.007). However, there were no statistically significant among fasting insulin(FINS), postprandial blood glucose(PG), postprandial insulin(PI), and triglycerides(TG) in overweight and obese adults. In subgroup analysis, FPG was statistically significant in German, quality score 4, 150-200 g intake of whole grain, and health subgroups of each population. There was no statistical significance of the QUICKI group. In sensitivity analysis and publication bias, FINS, PG, PI and TG became significant after one article was removed. However, HOMA-IR result were not statistically significant after the removal of one article. Meanwhile, the publication bias of each index was analyzed by Egger regression. Based on the results of subgroup analysis, a further dose-response analysis was conducted on the whole grains intake. The result showed that the FPG effects scale was better when the daily intake of whole grains was between 140 g and 160 g.

CONCLUSION: Daily intake of 140 g to 160 g of whole grains improves FPG levels in overweight and obese adults.

PMID:37062696 | DOI:10.19813/j.cnki.weishengyanjiu.2023.02.019

Wei Sheng Yan Jiu. 2023 Mar;52(2):188-192. doi: 10.19813/j.cnki.weishengyanjiu.2023.02.003.

ABSTRACT

OBJECTIVE: To explore the relationship between red meat intake and the prevalence of diabetes.

METHODS: Using the data of the China Health and Nutrition Survey in 1997, 2000, 2004, 2006, 2009, 2011, 2015 and 2018, 1154 people aged 18-75 years were included, and age, gender, urban and rural, education, marital status, income, occupational physical activity, total energy intake, fat energy ratio, smoking, drinking, body mass index and hypertension were adjusted. The Cox proportional hazard regression analysis was used to calculate diabetes hazard ratio(HR) and corresponding 95%CI.

RESULTS: In the study population, the per capita intake of red meat increased from 40.59 g/d in 1997 to 73.91 g/d in 2018, and the prevalence of diabetes rose from 6.14% in 2009 to 7.00% in 2018. In the early adjustment model, compared with the control group, the red meat intake HR of 1-39 g/d group was 0.92(95% CI 0.51-1.68), and the HR of 40-74 g/d group was 0.86(95% CI 0.47-1.58), and the HR of the group ≥75 g/d was 1.02(95% CI 0.62-1.68). In model 2, compared with the control group, the red meat intake HR of 1-39 g/d group was 0.71(95% CI 0.37-1.35), and the HR of 40-74 g/d group was 0.71(95% CI 0.38-1.35), the HR of ≥75 g/d group was 1.06(95% CI 0.69-1.87). In the fully adjusted model, compared with the control group, the red meat intake HR of 1-39 g/d group was 0.75(95% CI 0.61-1.55), the HR of 40-74 g/d group was 0.66(95% CI 0.57-1.43), and the HR of ≥75 g/d group was 1.27(95% CI 0.87-2.04).

CONCLUSION: With the increase of red meat intake, the prevalence of diabetes was also increasing, but there was no statistically significant association.

PMID:37062680 | DOI:10.19813/j.cnki.weishengyanjiu.2023.02.003

Wei Sheng Yan Jiu. 2023 Mar;52(2):173-178. doi: 10.19813/j.cnki.weishengyanjiu.2023.02.001.

ABSTRACT

OBJECTIVE: To investigate the dietary consumption of branched-chain amino acids(BCAAs)intake status of middle-aged and elderly people 50 years and older in China, and to analyze the distribution differences between different ages, genders and regions.

METHODS: The research sample was derived from the 2015 Chinese adult chronic disease and nutrition monitoring data. The survey adopts the stratified multi-stage cluster random sampling method, and selects 298 monitoring points from 31 provinces(autonomous regions and municipalities), a total of 44 218 people aged 50 years and over were sampled. Condiment weighing method, 24-hour dietary review method, and weighing method were used to obtain individual dietary data, and the dietary BCAAs intake of middle-aged and elderly people was calculated based on the Chinese Food Composition Table.

RESULTS: In 2015, the dietary BCAAs of middle-aged and elderly people in China accounted for 45.1% of leucine, 29.8% of valine and 25.1% of isoleucine. The top six dietary sources were cereals, red meat, vegetables, fish and seafood, beans and eggs. There were differences in the intake of three branched-chain amino acids(F=1926.67, P&lt;0.01), the intake of leucine was greater than that of valine, and the intake of valine was greater than isoleucine. There were statistically significant differences in dietary BCAAs intake between different age groups, genders, urban and rural areas and regions(P&lt;0.01), among which men were greater than women(t=12.89, P&lt;0.01), and the south was greater than the north(t=-6.36, P&lt;0.01), the eastern part was larger than the central part, and the central part was larger than the western part(F=82.42, P&lt;0.01). The intake of BCAAs decreased with the increase of age groups(F=22.69, P&lt;0.01), and there was no significant difference in age groups over 70 years old. The dietary intake of BCAAs was higher in the eastern coastal areas and Inner Mongolia, Xinjiang and Tibet.

CONCLUSION: There were gender, age and geographical differences in dietary BCAAs intake among middle-aged and elderly people in China, and the contribution of various foods to dietary BCAAs was also different.

PMID:37062678 | DOI:10.19813/j.cnki.weishengyanjiu.2023.02.001

J Cardiothorac Vasc Anesth. 2023 Mar 17:S1053-0770(23)00181-7. doi: 10.1053/j.jvca.2023.03.012. Online ahead of print.

ABSTRACT

OBJECTIVE: Despite inherent comorbidities, obese cardiac surgical patients paradoxically had shown lower morbidity and mortality, although the nature of this association is still unclear. Thus, the authors intended in this large registry-based study to investigate the impact of obesity on short- and long-term postoperative outcomes, focusing on bleeding and transfusion requirements.

DESIGN: Retrospective registry study.

SETTING: Three university hospitals.

PARTICIPANTS: A cohort of 12,330 prospectively compiled data from coronary bypass grafting patients undergoing surgery between 2007 to 2020 were retrieved from the Western Denmark Heart Registry.

INTERVENTIONS: The parameters were analyzed to assess the association between body mass index (BMI) and the selected outcome parameters.

MEASUREMENTS AND MAIN RESULTS: The crude data showed a clear statistically significant association in postoperative drainage from 637 (418-1108) mL in underweight patients with BMI <18.5 kg/m² to 427 (295-620) mL in severely obese patients with BMI ≥40 kg/m² (p < 0.0001, Kruskal-Wallis). Further, 50.0% of patients with BMI <18.5 received an average of 451 mL/m² in red blood cell transfusions, compared to 16.7% of patients with BMI >40 receiving 84 mL/m². The obese groups were less often submitted to reexploration due to bleeding, and fewer received perioperative hemostatics, inotropes, and vasoconstrictors. The crude data showed increasing 30-day and 6-month mortality with lower BMI, whereas the one-year mortality showed a V-shaped pattern, but BMI had no independent impact on mortality in logistic regression analysis.

CONCLUSION: Patients with high BMI may carry protection against postoperative bleeding after cardiac surgery, probably secondary to an inherent hypercoagulable state, whereas underweight patients carry a higher risk of bleeding and worse outcomes.

PMID:37062665 | DOI:10.1053/j.jvca.2023.03.012