Category: Nevin Manimala

J Orthop Surg Res. 2023 Mar 3;18(1):166. doi: 10.1186/s13018-023-03648-1.

ABSTRACT

OBJECTIVE: Pediatric elbow fractures are children’s most common fractures. People use the internet to get information about their illnesses and also to search for treatment options. Videos uploaded to Youtube do not go through the review process. The aim of our study is to determine the quality of videos related to child elbow fractures on Youtube.

MATERIAL METHOD: The study was carried out with the data obtained from the video-sharing site www.youtube.com on 01.12.2022. Pediatric elbow fractures are written in the search engine section. Information about the number of views of the videos, upload date, view rate (number of views per day), number of comments, number of likes and dislikes, duration, whether they contain animation and the publishing source were evaluated. The videos are divided into 5 groups according to their sources: medical society/non-profit organization, physician, healthrelated website, university/academic, and patient/independent user/other. The quality of the videos was evaluated using the Global Quality Scale (GQS). All videos have been evaluated by 2 researchers.

RESULTS: In the study, 50 videos were included. In the statistical evaluation, no significant correlation was found between the modified discern score and GQS found by both researchers, and the number of views, the rate of views, comments, likes and dislikes, video duration and VPI. In addition, when the GQS and modified discern scores were compared according to the source of the video, it was found that the patient/independent user/other group scores were lower numerically, but there was no statistically significant difference in comparison.

CONCLUSION: Most of the videos about child elbow fractures have been uploaded by healthcare professionals. Therefore, we concluded that the videos are quite informative in terms of accurate information and quality content.

PMID:36869361 | DOI:10.1186/s13018-023-03648-1

J Ovarian Res. 2023 Mar 3;16(1):49. doi: 10.1186/s13048-023-01128-y.

ABSTRACT

BACKGROUND: Vitrified M-II oocyte accumulation for later simultaneous insemination has been used for managing POR. Our study aimed to determine whether vitrified oocyte accumulation strategy improves live birth rate (LBR) for managing diminished ovarian reserve (DOR).

METHODS: A retrospective study included 440 women with DOR fulfilling Poseidon classification groups 3 and 4, defined as the presence of serum anti-Müllerian hormone (AMH) hormone level < 1.2 ng/ml or antral follicle count (AFC) < 5, from January 1, 2014, to December 31, 2019, in a single department. Patients underwent accumulation of vitrified oocytes (DOR-Accu) and embryo transfer (ET) or controlled ovarian stimulation (COS) using fresh oocytes (DOR-fresh) and ET. Primary outcomes were LBR per ET and cumulative LBR (CLBR) per intention to treat (ITT). Secondary outcomes were clinical pregnancy rate (CPR) and miscarriage rate (MR).

RESULTS: Two hundred eleven patients underwent simultaneous insemination of vitrified oocyte accumulation and ET in the DOR-Accu group (maternal age: 39.29 ± 4.23 y, AMH: 0.54 ± 0.35 ng/ml), and 229 patients underwent COS and ET in the DOR-fresh group (maternal age: 38.07 ± 3.77 y, AMH: 0.72 ± 0.32 ng/ml). CPR in the DOR-Accu group was similar in the DOR-fresh group (27.5% vs. 31.0%, p = 0.418). However, MR was statistically higher (41.4% vs. 14.1%, p = 0.001), while LBR per ET was statistically lower (15.2% vs. 26.2%, p < 0.001) in the DOR-Accu group. There is no difference in CLBR per ITT between groups (20.4% vs. 27.5%, p = 0.081). The secondary analysis categorized clinical outcomes into four groups regarding patients’ age. CPR, LBR per ET, and CLBR did not improve in the DOR-Accu group. In the group of 31 patients, accumulated vitrified metaphase II (M-II) oocytes reached a total number of ≥ 15, and CPR improved among the DOR-Accu group (48.4% vs. 31.0%, p = 0.054); however, higher MR (40.0% vs. 14.1%, p = 0.03) resulted in similar LBR per ET (29.0% vs. 26.2%, p = 0.738).

CONCLUSIONS: Vitrified oocyte accumulation for managing DOR did not improve LBR. Higher MR resulted in lower LBR in the DOR-Accu group. Therefore, the vitrified oocyte accumulation strategy for managing DOR is not clinically practical.

TRIAL REGISTRATION: The study protocol was retrospectively registered and was approved by Institutional Review Board of Mackay Memorial Hospital (21MMHIS219e) on August 26, 2021.

PMID:36869354 | DOI:10.1186/s13048-023-01128-y

J Orthop Surg Res. 2023 Mar 3;18(1):163. doi: 10.1186/s13018-023-03646-3.

ABSTRACT

PURPOSE: It has been widely reported that femoral anteversion is a risk factor for patellar dislocation. This study aims to evaluate whether internal torsion of the distal femur is noticeable in patients without increased femoral anteversion and to assess whether it is a risk factor for patellar dislocation.

METHODS: A retrospective analysis was conducted on 35 patients (24 females, 11 males) with recurrent patellar dislocation but without increased femoral anteversion treated in our hospital from January 2019 to August 2020. All patients underwent knee X-rays, digital radiography of lower-limbs, and CT scans of hip, knee, and ankle joints to measure femoral anteversion angle, distal femoral torsion angle, TT-TG and Caton-Deschamps index. Thirty-five control cases were matched on age and sex to compare the difference of anatomic parameters between the two groups, and the logistic analysis was used to analyze risk factors for patellar dislocation. Perman correlation coefficient was used to evaluate the correlation among femoral anteversion, distal femoral torsion and TT-TG.

RESULTS: Greater distal femoral torsion was still observed in patients with patellar dislocation but without increased femoral anteversion. The torsion angle of distal femur, TT-TG distance and incidence of Patella Alta in patients with patellar dislocation were greater than those in control group, and the inter-group differences were statistically significant (P < 0.05). The torsion angle of distal femur (OR = 2.848, P < 0.001), TT-TG distance (OR = 1.163, P = 0.021) and Patella Alta (OR = 3.545, P = 0.034) were risk factors for patellar dislocation. However, no significant correlation was found among femoral anteversion, distal femoral torsion and TT-TG in patients with patellar dislocation.

CONCLUSION: On the condition that femoral anteversion did not increase, increased distal femoral torsion was commonly observed in patients with patellar dislocation, which represents an independent risk factor for patellar dislocation.

PMID:36869339 | DOI:10.1186/s13018-023-03646-3

BMC Cancer. 2023 Mar 3;23(1):204. doi: 10.1186/s12885-023-10669-w.

ABSTRACT

BACKGROUND: Laparoscopic colorectal surgery has been proved to have similar oncological outcomes with open surgery. Due to the lack of tactile perception, surgeons may have misjudgments in laparoscopic colorectal surgery. Therefore, the accurate localization of a tumor before surgery is important, especially in the early stages of cancer. Autologous blood was thought a feasible and safe tattooing agent for preoperative endoscopic localization but its benefits remain controversial. We therefore proposed this randomized trial to the accuracy and safety of autogenous blood localization in small, serosa-negative lesion which will be resected by laparoscopic colectomy.

METHODS: The current study is a single-center, open-label, non-inferiority, randomized controlled trial. Eligible participants would be aged 18-80 years and diagnosed with large lateral spreading tumors that could not be treated endoscopically, malignant polyps treated endoscopically that required additional colorectal resection, and serosa-negative malignant colorectal tumors (≤ cT3). A total of 220 patients would be randomly assigned (1:1) to autologous blood group or intraoperative colonoscopy group. The primary outcome is the localization accuracy. The secondary endpoint is adverse events related to endoscopic tattooing.

DISCUSSION: This trial will investigate whether autologous blood marker achieves similar localization accuracy and safety in laparoscopic colorectal surgery compared to intraoperative colonoscopy. If our research hypothesis is statistically proved, the rational introduction of autologous blood tattooing in preoperative colonoscopy can help improve identification of the location of tumors for laparoscopic colorectal cancer surgery, performing an optimal resection, and minimizing unnecessary resections of normal tissues, thereby improving the patient’s quality of life. Our research data will also provide high quality clinical evidence and data support for the conduction of multicenter phase III clinical trials.

TRIAL REGISTRATION: This study is registered with ClinicalTrials.gov, NCT05597384. Registered 28 October 2022.

PMID:36869328 | DOI:10.1186/s12885-023-10669-w

BMC Med Educ. 2023 Mar 3;23(1):147. doi: 10.1186/s12909-023-04075-w.

ABSTRACT

BACKGROUND: As delayed family building is common among physicians, the goal of this study was to evaluate childbearing plans, anxiety related to future fertility, and interest in fertility education among medical students.

METHODS: Using convenience and snowball sampling methods, an electronic REDCap survey was distributed via social media and group messaging applications to medical students enrolled in medical schools across the United States. Answers were collected, and analysis of the descriptive statistics was performed.

RESULTS: The survey was completed by 175 participants, 72% of which were female (assigned at birth). The mean (± SD) age of participants was 24.9 ± 1.9 years. Of all participants, 78.3% desire to have children and 65.1% of these individuals plan to delay childbearing. On average, the planned age of first pregnancy is 31.0 ± 2.3 years. “Lack of time” was the greatest influence on decision regarding timing of childbearing. Of all respondents, 58.9% reported at least some anxiety related to future fertility. When females and males were compared, significantly more females (73.8%) versus males (20.4%) reported worrying about future fertility (p < 0.001). Participants reported that greater knowledge about infertility and potential treatments would help ease fertility related anxiety, and 66.9% of respondents showed interest in learning about how things such as age and lifestyle can impact fertility, preferably through medical curricula, videos, and podcasts.

CONCLUSION: A majority of the medical students in this cohort intend to have children and most plan to delay childbearing. A large percentage of female medical students reported anxiety related to future fertility, but many students showed interest in receiving fertility education. This study highlights an opportunity for medical school educators to incorporate targeted fertility education into their curriculum with the intention of decreasing anxiety and improving future reproductive success.

PMID:36869311 | DOI:10.1186/s12909-023-04075-w

BMC Geriatr. 2023 Mar 3;23(1):118. doi: 10.1186/s12877-023-03840-2.

ABSTRACT

BACKGROUND: Older adults with cognitive decline need physical activity for maintaining brain health and mitigating cognitive decline. Tai Chi is a safe and gentle aerobic exercise and has been recommended for people with various health conditions to improve their physical functioning, well-being, and quality of life (QoL). This study aimed to determine the feasibility of a 12-week program of Tai Chi for memory (TCM) among older adults with mild cognitive impairment (MCI) or dementia; and to determine the pilot effects of TCM on physical functioning, depression, and health-related QoL.

METHODS: A quasi-experimental design was used with two groups: MCI and dementia. The feasibility of the 12-week TCM program was assessed after it finished in terms of its acceptability, demand, implementation, practicality, adaptation, integration, expansion, and limited-efficacy testing. Other health-related outcomes, physical functioning, depression, and health-related QoL were measured before and after the TCM program. Outcome measures consist of a digital hand dynamometer for grip strength, the standard sit-and-reach test, the one-leg-standing balance test, timed up and go (TUG) test, the Korean version of the Geriatric Depression Scale, and the 12-item Short Form survey (SF-12). Paired and independent t-tests were used to compare the effects of TCM within and between groups.

RESULTS: The TCM program was completed by 41 participants with MCI (n = 21) or dementia (n = 20), and its accepted feasibility was assessed. After TCM, the MCI group exhibited significant enhancements in right-hand grip strength (t = – 2.13, p = .04) and physical-health-related QoL (t = – 2.27, p = .03). TUG scores improved in both groups (MCI, t = 3.96 p = .001; dementia, t = 2.54 p = .02). The adopted form of the TCM program was effectively and safely applied to those with various levels of cognitive impairment. The program was well accepted by the participants with a mean attendance rate of 87%. No adverse events were reported during the program.

CONCLUSION: TCM has the potential to improve physical functioning and QoL. Since there was no comparison group to control for confounding factors and low statistical power in the present study, further studies are warranted with a stronger design that includes longer follow-up periods. This protocol was retrospectively registered on Dec 1, 2022 (NCT05629650) at ClinicalTrials.gov.

PMID:36869290 | DOI:10.1186/s12877-023-03840-2

Ir J Med Sci. 2023 Mar 3. doi: 10.1007/s11845-023-03325-6. Online ahead of print.

ABSTRACT

BACKGROUND: Gene regulation of IL-6 is characterized by the presence of inflammatory cytokines, bacterial products, viral infection, and activation of the diacylglycerol-, cyclic AMP-, or Ca + + -activated signal transduction pathways.

AIM: Scaling and root planning (SRP), a non-surgical periodontal therapy, was studied in connection to several clinical parameters for its effect on salivary IL-6 levels in patients with generalized chronic periodontitis.

METHODS: For this study, a total of 60 GCP patients were included. Plaque index (PI), gingival index (GI), pocket probing depth (PPD), bleeding on probing percentage (BOP%), and clinical attachment loss were among the clinical indicators covered (CAL).

RESULTS: Following SRP, mean IL-6 levels in patients with GCP were significantly higher in the pre-treatment group (2.93 5.17 pg/ml; p 0.05) than in the posttreatment group (5.78 8.26 pg/ml; baseline). Pre- and post-treatment IL-6 levels for PI (pre), BOP percent (pre/post), GI (post), and PPD were found to be positively correlated (post). In patients with GCP, the study showed a statistically significant correlation between periodontal metrics and salivary IL-6.

CONCLUSIONS: Changes in periodontal indices and IL-6 levels that are statistically significant over time indicate that non-surgical treatment is effective, and IL-6 can be regarded as a potent disease activity marker.

PMID:36869249 | DOI:10.1007/s11845-023-03325-6

Eur Arch Psychiatry Clin Neurosci. 2023 Mar 4. doi: 10.1007/s00406-023-01572-3. Online ahead of print.

ABSTRACT

Vitamin deficiency syndromes and blood-brain barrier (BBB) dysfunction are frequent phenomena in psychiatric conditions. We analysed the largest available first-episode schizophrenia-spectrum psychosis (FEP) cohort to date regarding routine cerebrospinal fluid (CSF) and blood parameters to investigate the association between vitamin deficiencies (vitamin B12 and folate) and BBB impairments in FEP. We report a retrospective analysis of clinical data from all inpatients that were admitted to our tertiary care hospital with an ICD-10 diagnosis of a first-episode F2x (schizophrenia-spectrum) between January 1, 2008 and August 1, 2018 and underwent a lumbar puncture, blood-based vitamin status diagnostics and neuroimaging within the clinical routine. 222 FEP patients were included in our analyses. We report an increased CSF/serum albumin quotient (Qalb) as a sign of BBB dysfunction in 17.1% (38/222) of patients. White matter lesions (WML) were present in 29.3% of patients (62/212). 17.6% of patients (39/222) showed either decreased vitamin B12 levels or decreased folate levels. No statistically significant association was found between vitamin deficiencies and altered Qalb. This retrospective analysis contributes to the discussion on the impact of vitamin deficiency syndromes in FEP. Although decreased vitamin B12 or folate levels were found in approximately 17% of our cohort, we found no evidence for significant associations between BBB dysfunction and vitamin deficiencies. To strengthen the evidence regarding the clinical implications of vitamin deficiencies in FEP, prospective studies with standardized measurements of vitamin levels together with follow-up measurements and assessment of symptom severity in addition to CSF diagnostics are needed.

PMID:36869234 | DOI:10.1007/s00406-023-01572-3

Cancer Immunol Immunother. 2023 Mar 3. doi: 10.1007/s00262-023-03384-9. Online ahead of print.

ABSTRACT

BACKGROUND: Immune checkpoint inhibitors (ICIs) have particular, immune-related adverse events (irAEs), as a consequence of interfering with self-tolerance mechanisms. The incidence of irAEs varies depending on ICI class, administered dose and treatment schedule. The aim of this study was to define a baseline (T0) immune profile (IP) predictive of irAE development.

METHODS: A prospective, multicenter study evaluating the immune profile (IP) of 79 patients with advanced cancer and treated with anti-programmed cell death protein 1 (anti-PD-1) drugs as a first- or second-line setting was performed. The results were then correlated with irAEs onset. The IP was studied by means of multiplex assay, evaluating circulating concentration of 12 cytokines, 5 chemokines, 13 soluble immune checkpoints and 3 adhesion molecules. Indoleamine 2, 3-dioxygenase (IDO) activity was measured through a modified liquid chromatography-tandem mass spectrometry using the high-performance liquid chromatography-mass spectrometry (HPLC-MS/MS) method. A connectivity heatmap was obtained by calculating Spearman correlation coefficients. Two different networks of connectivity were constructed, based on the toxicity profile.

RESULTS: Toxicity was predominantly of low/moderate grade. High-grade irAEs were relatively rare, while cumulative toxicity was high (35%). Positive and statistically significant correlations between the cumulative toxicity and IP10 and IL8, sLAG3, sPD-L2, sHVEM, sCD137, sCD27 and sICAM-1 serum concentration were found. Moreover, patients who experienced irAEs had a markedly different connectivity pattern, characterized by disruption of most of the paired connections between cytokines, chemokines and connections of sCD137, sCD27 and sCD28, while sPDL-2 pair-wise connectivity values seemed to be intensified. Network connectivity analysis identified a total of 187 statistically significant interactions in patients without toxicity and a total of 126 statistically significant interactions in patients with toxicity. Ninety-eight interactions were common to both networks, while 29 were specifically observed in patients who experienced toxicity.

CONCLUSIONS: A particular, common pattern of immune dysregulation was defined in patients developing irAEs. This immune serological profile, if confirmed in a larger patient population, could lead to the design of a personalized therapeutic strategy in order to prevent, monitor and treat irAEs at an early stage.

PMID:36869232 | DOI:10.1007/s00262-023-03384-9

Behav Res Methods. 2023 Mar 3. doi: 10.3758/s13428-023-02072-x. Online ahead of print.

ABSTRACT

Statistical methods generally have assumptions (e.g., normality in linear regression models). Violations of these assumptions can cause various issues, like statistical errors and biased estimates, whose impact can range from inconsequential to critical. Accordingly, it is important to check these assumptions, but this is often done in a flawed way. Here, I first present a prevalent but problematic approach to diagnostics-testing assumptions using null hypothesis significance tests (e.g., the Shapiro-Wilk test of normality). Then, I consolidate and illustrate the issues with this approach, primarily using simulations. These issues include statistical errors (i.e., false positives, especially with large samples, and false negatives, especially with small samples), false binarity, limited descriptiveness, misinterpretation (e.g., of p-value as an effect size), and potential testing failure due to unmet test assumptions. Finally, I synthesize the implications of these issues for statistical diagnostics, and provide practical recommendations for improving such diagnostics. Key recommendations include maintaining awareness of the issues with assumption tests (while recognizing they can be useful), using appropriate combinations of diagnostic methods (including visualization and effect sizes) while recognizing their limitations, and distinguishing between testing and checking assumptions. Additional recommendations include judging assumption violations as a complex spectrum (rather than a simplistic binary), using programmatic tools that increase replicability and decrease researcher degrees of freedom, and sharing the material and rationale involved in the diagnostics.

PMID:36869217 | DOI:10.3758/s13428-023-02072-x