Category: Nevin Manimala

Plast Reconstr Surg. 2023 Apr 13. doi: 10.1097/PRS.0000000000010529. Online ahead of print.

ABSTRACT

BACKGROUND: To evaluate the long-term outcomes of mandibular reconstruction with vascularized free fibula flap in pediatric patients.

METHODS: Consecutive cases of mandibular reconstruction with vascularized free fibula flaps in pediatric patients at Peking University School and Hospital of Stomatology between 1999 and 2019 were reviewed. Postoperative computed tomography (CT) data of all patients were collected at each postoperative follow-up point, and after the age of 18 years. The length and height of the grafted fibula and the length of the remaining mandible were evaluated by measuring the three-dimensional CT data using ProPlan CMF 3.0 software. Lower limb function was evaluated using the Enneking evaluation scale. Facial symmetry was self-evaluated and scored. Statistical analysis was performed on the data obtained.

RESULTS: Fourteen patients were included in this study. All flaps were successful. The CT measurement results showed growth in the length of the grafted fibula which reconstructed the mandibular ramus and the residual mandible (P < 0.05). The height of the grafted fibula remained stable (P > 0.05). Eight patients were followed-up until > 18 years of age, and the CT measurement results after 18 years showed an essentially symmetrical mandible profile (P > 0.05). All patients were satisfied with their postoperative facial symmetry. Enneking evaluation scores showed good recovery of lower limb functions.

CONCLUSION: Vascularized free fibula flap for mandibular reconstruction in pediatric patients is safe and reliable while also providing good cosmetic and functional outcomes as it demonstrated positive growth.

PMID:37053458 | DOI:10.1097/PRS.0000000000010529

Health Psychol. 2023 Apr 13. doi: 10.1037/hea0001278. Online ahead of print.

ABSTRACT

OBJECTIVE: There is a tremendous opportunity for electronic health services (eHealth) to reach adults with low income who want to participate in weight loss interventions, but face barriers in access. This review (a) synthesizes and presents results from all studies evaluating the effectiveness of eHealth weight loss interventions for adults with low income and (b) describes the strategies used to tailor them to these groups.

METHOD: Electronic databases were searched for studies examining the effectiveness of eHealth weight loss interventions designed for adults with low income and screened for eligibility by two independent reviewers. All experimental study designs were included. Data were extracted, results were qualitatively synthesized, and studies were assessed for quality.

RESULTS: Nine studies met the inclusion criteria (N = 1,606 total participants). Four studies reported significant reductions in weight of small to moderate magnitude among participants in eHealth interventions (M weight loss = -2.2 kg; SD = 1.6). Many studies did not describe how they tailored the intervention for adults with low income; however, studies that achieved significant results tended to use more tailoring strategies. Most studies reported high retention rates. Three studies were rated as strong quality, four as moderate, and two as weak.

CONCLUSIONS: Evidence is limited that eHealth weight loss interventions for this population are effective in achieving clinically and statistically significant weight reductions. While interventions that used more tailoring strategies tended to be more effective, studies that use the rigorous methodology and describe interventions in more depth could better elucidate whether eHealth interventions are an effective approach in this population. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37053431 | DOI:10.1037/hea0001278

J Exp Psychol Learn Mem Cogn. 2023 Apr 13. doi: 10.1037/xlm0001240. Online ahead of print.

ABSTRACT

Previous masked translation priming studies, especially those with different-script bilinguals, have shown that cognates provide more priming than noncognates, a difference attributed to cognates’ phonological similarity. In our experiments employing a word naming task, we examined this issue for Chinese-Japanese bilinguals in a slightly different way, using same-script cognates as primes and targets. In Experiment 1, significant cognate priming effects were observed. The sizes of the priming effects were, however, statistically not different for phonologically similar (e.g., /xin4lai4/-/shiNrai/) and dissimilar cognate pairs (e.g., /bao3zheng4/- /hoshoR/), suggesting no impact of phonological similarity. In Experiment 2, using exclusively Chinese stimuli, we demonstrated a significant homophone priming effect using two-character logographic primes and targets, indicating that phonological priming is possible for two-character Chinese targets. However, priming only emerged for pairs that had the same tone pattern (e.g., /shou3wei4/-/shou3wei4/), suggesting that a match in lexical tone is crucial for observing phonologically based priming in that situation. Therefore, Experiment 3 involved phonologically similar Chinese-Japanese cognate pairs in which the similarity of their suprasegmental phonological features (i.e., lexical tone and pitch-accent information) was varied. Priming effects were statistically not different for tone/accent similar pairs (e.g., /guan1xin1/-/kaNsiN/) and dissimilar pairs (e.g., /man3zu2/-/maNzoku/). Our results indicate that phonological facilitation is not involved in producing cognate priming effects for Chinese-Japanese bilinguals. Possible explanations, based on underlying representations of logographic cognates, are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37053424 | DOI:10.1037/xlm0001240

Psychol Methods. 2023 Apr 13. doi: 10.1037/met0000565. Online ahead of print.

ABSTRACT

artially nested designs (PNDs) are common in intervention studies in psychology and other social sciences. With this design, participants are assigned to treatment and control groups on an individual basis, but clustering occurs in some but not all groups (e.g., the treatment group). In recent years, there has been substantial development of methods for analyzing data from PNDs. However, little research has been done on causal inference for PNDs, especially for PNDs with nonrandomized treatment assignments. To reduce the research gap, in the current study, we used the expanded potential outcomes framework to define and identify the average causal treatment effects in PNDs. Based on the identification results, we formulated the outcome models that could produce treatment effect estimates with causal interpretation and evaluated how alternative model specifications affect the causal interpretation. We also developed an inverse propensity weighted (IPW) estimation approach and proposed a sandwich-type standard error estimator for the IPW-based estimate. Our simulation studies demonstrated that both the outcome modeling and the IPW methods specified following the identification results can yield satisfactory estimates and inferences of the average causal treatment effects. We applied the proposed approaches to data from a real-life pilot study of the Pregnant Moms’ Empowerment Program for illustration. The current study provides guidance and insights on causal inference for PNDs and adds to researchers’ toolbox of treatment effect estimation with PNDs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37053414 | DOI:10.1037/met0000565

Emotion. 2023 Apr 13. doi: 10.1037/emo0001236. Online ahead of print.

ABSTRACT

Emotional acceptance is thought to play an important role in protecting mental health. However, few studies have examined emotional acceptance among older adults who may experience declines in functioning, including executive functioning. The present laboratory-based study examined whether emotional acceptance and (to determine specificity) detachment and positive reappraisal moderated links between executive functioning and mental health symptoms in a sample of healthy older adults. Emotion regulation strategies were measured using questionnaire-based measures (using established questionnaires) as well as performance-based measures (instructing individuals to use emotional acceptance, detachment, and positive reappraisal in response to sad film clips). Executive functioning was measured using a battery of working memory, inhibition, and verbal fluency tasks. Mental health symptoms were measured using questionnaires to assess anxiety and depressive symptoms. Results showed that (a) emotional acceptance moderated the link between executive functioning and mental health such that lower executive functioning predicted higher levels of anxiety and depressive symptoms at low but not at high levels of emotional acceptance. Moderation effects tended to be (b) stronger for emotional acceptance compared to the other emotion regulation strategies (though not all comparisons were statistically significant). Findings were (c) robust when controlling for age, gender, and education for questionnaire-based (but not performance-based) emotional acceptance. These findings contribute to the literature on emotion regulation specificity and highlight the mental health benefits of emotional acceptance in the face of low executive functioning. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37053410 | DOI:10.1037/emo0001236

J Exp Psychol Gen. 2023 Apr 13. doi: 10.1037/xge0001368. Online ahead of print.

ABSTRACT

People can quickly learn spatial distributions of targets and direct attention to likely regions of targets. These implicitly learned spatial biases have been shown to be persistent, transferring to other similar visual search tasks. However, a persistent attentional bias is incompatible with frequently changing goals in our typical daily environment. We propose a flexible goal-specific probability cueing mechanism to address this discrepancy. We examined whether participants could learn and utilize target-specific spatial priority maps across five experiments (each N = 24). In Experiment 1, participants were faster to find the target at the target-specific high-probability location, in line with a goal-specific probability cueing effect. This demonstrated that separate spatial priorities derived from statistical learning can be flexibly activated based on the current goal. In Experiment 2, we ensured the results were not driven solely by intertrial priming. In Experiment 3, we ensured the results were driven by early attentional guidance effects. In Experiment 4, we extended our findings to a complex spatial distribution including four locations, supporting a sophisticated representation of target likelihood in the activated spatial priority maps. Finally, in Experiment 5, we confirmed that the effect was driven by the activation of an attentional template and not associative learning between the target cue and a spatial location. Our findings demonstrate a previously unrecognized mechanism for flexibility within statistical learning. The goal-specific probability cueing effect relies on coordination of feature-based and location-based attention, utilizing information that crosses traditional boundaries between top-down control and selection history. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

PMID:37053400 | DOI:10.1037/xge0001368

J Am Med Inform Assoc. 2023 Apr 13:ocad064. doi: 10.1093/jamia/ocad064. Online ahead of print.

ABSTRACT

OBJECTIVE: To study the coverage and challenges in mapping 3 national and international procedure coding systems to the International Classification of Health Interventions (ICHI).

MATERIALS AND METHODS: We identified 300 commonly used codes each from SNOMED CT, ICD-10-PCS, and CCI (Canadian Classification of Health Interventions) and mapped them to ICHI. We evaluated the level of match at the ICHI stem code and Foundation Component levels. We used postcoordination (modification of existing codes by adding other codes) to improve matching. Failure analysis was done for cases where full representation was not achieved. We noted and categorized potential problems that we encountered in ICHI, which could affect the accuracy and consistency of mapping.

RESULTS: Overall, among the 900 codes from the 3 sources, 286 (31.8%) had full match with ICHI stem codes, 222 (24.7%) had full match with Foundation entities, and 231 (25.7%) had full match with postcoordination. 143 codes (15.9%) could only be partially represented even with postcoordination. A small number of SNOMED CT and ICD-10-PCS codes (18 codes, 2% of total), could not be mapped because the source codes were underspecified. We noted 4 categories of problems in ICHI-redundancy, missing elements, modeling issues, and naming issues.

CONCLUSION: Using the full range of mapping options, at least three-quarters of the commonly used codes in each source system achieved a full match. For the purpose of international statistical reporting, full matching may not be an essential requirement. However, problems in ICHI that could result in suboptimal maps should be addressed.

PMID:37053378 | DOI:10.1093/jamia/ocad064

Gastroenterol Nurs. 2023 Apr 12. doi: 10.1097/SGA.0000000000000722. Online ahead of print.

ABSTRACT

The objective of this study was to describe the COVID-19 intensive care unit population and analyze the characteristics and outcomes of gastrointestinal bleeding patients. An observational prospective study design was used following the STROBE checklist. All patients admitted between February and April 2020 to the intensive care unit were included. Main outcome measures were first bleeding event timing, sociodemographic and clinical data before admission, and gastrointestinal symptoms. A total of 116 COVID-19 patients were included; 16 (13.8%) developed gastrointestinal bleeding, 15 were males (93.7%), and the median age was 65.64 ± 7.33 years. All 16 patients were mechanically ventilated, one (6.3%) already had gastrointestinal symptoms, 13 (81.3%) had at least one concomitant disease, and six (37.5%) died. Bleeding episodes occurred on a mean of 16.9 ± 9.5 days after admission. Nine cases (56.3%) had effects on their hemodynamics, hemoglobin levels, or transfusion requirements; six (37.5%) required diagnostic imaging; and two (12.5%) underwent endoscopy procedures. The Mann-Whitney test showed statistically significant differences between the two groups of patients concerning comorbidities. Gastrointestinal bleeding can occur in critically ill patients with COVID-19. Having a solid tumor or chronic liver disease seems to increase that risk. Nurses caring for COVID-19 patients are urged to individualize patients at higher risk in order to improve safety.

PMID:37053376 | DOI:10.1097/SGA.0000000000000722

Clin Chem Lab Med. 2023 Apr 13. doi: 10.1515/cclm-2023-0158. Online ahead of print.

ABSTRACT

OBJECTIVES: According to international standards, clinical laboratories are required to verify the performance of assays prior to their implementation in routine practice. This typically involves the assessment of the assay’s imprecision and trueness vs. appropriate targets. The analysis of these data is typically performed using frequentist statistical methods and often requires the use of closed source, proprietary software. The motivation for this paper was therefore to develop an open-source, freely available software capable of performing Bayesian analysis of verification data.

METHODS: The veRification application presented here was developed with the freely available R statistical computing environment, using the Shiny application framework. The codebase is fully open-source and is available as an R package on GitHub.

RESULTS: The developed application allows the user to analyze imprecision, trueness against external quality assurance, trueness against reference material, method comparison, and diagnostic performance data within a fully Bayesian framework (with frequentist methods also being available for some analyses).

CONCLUSIONS: Bayesian methods can have a steep learning curve and thus the work presented here aims to make Bayesian analyses of clinical laboratory data more accessible. Moreover, the development of the application and seeks to encourage the dissemination of open-source software within the community and provides a framework through which Shiny applications can be developed, shared, and iterated upon.

PMID:37053372 | DOI:10.1515/cclm-2023-0158

Arkh Patol. 2023;85(2):5-12. doi: 10.17116/patol2023850215.

ABSTRACT

OBJECTIVE: To study the somatic mutational status of the FGFR3 gene in urothelial bladder cancer (BC) and evaluate its relationship with the clinical and morphological characteristics of the tumor, deficiency of the DNA mismatch repair (dMMR), PD-L1 tumor status, and immunohistochemical (IHC) expression of the p16 protein.

MATERIAL AND METHODS: Surgical material of 40 patients with BC, on which the mutational status of the FGFR3 gene was studied using the molecular genetic method, as well as the MMR status, PD-L1 and p16 expression by the IHC method.

RESULTS: FGFR3 mutations, such as G370C, S249C, S371C/Y373C, R248C, were detected in 35.0% of the studied BC samples. FGFR3 status did not depend on the gender and age of patients, as well as on the degree of tumor lymphoid infiltration (TILs). Statistically significant differences were found in the analysis of FGFR3 status depending on the histological structure and degree of tumor differentiation, as well as on the pT stage. The FGFR3 status of BC was not associated with the IHC expression of the studied proteins of the MMR system, as well as with the PD-L1 status. Higher levels of PD-L1 expression were demonstrated by BC tumor cells, in which no aberrations in FGFR3 were detected. There was no significant association between p16 status and the presence of FGFR3 mutations, but for FGFR3-positive carcinomas, the basal pattern of p16 staining by IHC was noted.

CONCLUSION: A positive somatic mutational status of the FGFR3 gene was statistically significantly more common in the group of papillary low-grade non-muscle-invasive BC, demonstrating basal p16 IHC staining. In the study sample, there was no statistically significant relationship between the FGFR3 status of BC and gender and age differences, TILs, MMR status, PD-L1 status (SP142 and 22C3), and p16 status. The results of the study indicate the need to determine the FGFR3 status in patients with BC for further prescription of personalized therapy.

PMID:37053347 | DOI:10.17116/patol2023850215