Category: Nevin Manimala

Can J Anaesth. 2023 May 8. doi: 10.1007/s12630-023-02426-1. Online ahead of print.

ABSTRACT

PURPOSE: Ancillary tests are frequently used in death determination by neurologic criteria (DNC), particularly when the clinical neurologic examination is unreliable. Nevertheless, their diagnostic accuracy has not been extensively studied. Our objective was to synthesize the sensitivity and specificity of commonly used ancillary tests for DNC.

SOURCE: We performed a systematic review and meta-analysis by searching MEDLINE, EMBASE, Cochrane databases, and CINAHL Ebsco from their inception to 4 February 2022. We selected cohort and case-control studies including patients with 1) clinically diagnosed death by neurologic criteria or 2) clinically suspected death by neurologic criteria who underwent ancillary testing for DNC. We excluded studies without a priori diagnostic criteria and studies conducted solely on pediatric patients. Accepted reference standards were clinical examination, four-vessel conventional angiography, and radionuclide imaging. Data were directly extracted from published reports. We assessed the methodological quality of studies with the QUADAS-2 tool and estimated ancillary test sensitivities and specificities using hierarchical Bayesian models with diffuse priors.

PRINCIPAL FINDINGS: Overall, 137 records met the selection criteria. One study (0.7%) had a low risk of bias in all QUADAS-2 domains. Among clinically diagnosed death by neurologic criteria patients (n = 8,891), ancillary tests had similar pooled sensitivities (range, 0.82-0.93). Sensitivity heterogeneity was greater within (σ = 0.10-0.15) than between (σ = 0.04) ancillary test types. Among clinically suspected death by neurologic criteria patients (n = 2,732), pooled ancillary test sensitivities ranged between 0.81 and 1.00 and specificities between 0.87 and 1.00. Most estimates had high statistical uncertainty.

CONCLUSION: Studies assessing ancillary test diagnostic accuracy have an unclear or high risk of bias. High-quality studies are required to thoroughly validate ancillary tests for DNC.

STUDY REGISTRATION: PROSPERO (CRD42013005907); registered 7 October 2013.

PMID:37155120 | DOI:10.1007/s12630-023-02426-1

Phys Eng Sci Med. 2023 May 8. doi: 10.1007/s13246-023-01265-0. Online ahead of print.

ABSTRACT

The combination of visual assessment of whole body [¹⁸F]FDG PET images and evaluation of bone marrow samples by Multiparameter Flow Cytometry (MFC) or Next-Generation Sequencing (NGS) is currently the most common clinical practice for the detection of Measurable Residual Disease (MRD) in Multiple Myeloma (MM) patients. In this study, radiomic features extracted from the bone marrow biopsy locations are analyzed and compared to those extracted from the whole bone marrow in order to study the representativeness of these biopsy locations in the image-based MRD assessment. Whole body [¹⁸F]FDG PET of 39 patients with newly diagnosed MM were included in the database, and visually evaluated by experts in nuclear medicine. A methodology for the segmentation of biopsy sites from PET images, including sternum and posterior iliac crest, and their subsequent quantification is proposed. First, starting from the bone marrow segmentation, a segmentation of the biopsy sites is performed. Then, segmentations are quantified extracting SUV metrics and radiomic features from the [¹⁸F]FDG PET images and are evaluated by Mann-Whitney U-tests as valuable features differentiating PET+/PET- and MFC+ /MFC- groups. Moreover, correlation between whole bone marrow and biopsy sites is studied by Spearman ρ rank. Classification performance of the radiomics features is evaluated applying seven machine learning algorithms. Statistical analyses reveal that some images features are significant in PET+/PET- differentiation, such as SUV_max, Gray Level Non-Uniformity or Entropy, especially with a balanced database where 16 of the features show a p value < 0.001. Correlation analyses between whole bone marrow and biopsy sites results in significant and acceptable coefficients, with 11 of the variables reaching a correlation coefficient greater than 0.7, with a maximum of 0.853. Machine learning algorithms demonstrate high performances in PET+/PET- classification reaching a maximum AUC of 0.974, but not for MFC+/MFC- classification. The results demonstrate the representativeness of sample sites as well as the effectiveness of extracted features (SUV metrics and radiomic features) from the [¹⁸F]FDG PET images in MRD assessment in MM patients.

PMID:37155114 | DOI:10.1007/s13246-023-01265-0

Environ Sci Pollut Res Int. 2023 May 8. doi: 10.1007/s11356-023-27417-z. Online ahead of print.

ABSTRACT

Hotter and drier weather conditions due to climate change negatively affect water resources and agricultural production. For this reason, it is vital to analyze the change in potential evapotranspiration (PET) values, which is one of the most important parameters related to plant growth and agricultural irrigation planning. This study analyses the trends and changes in monthly and annual PET values between 1965 and 2018 at Erzincan, Bayburt and Gümüşhane meteorological stations in Turkey. For this purpose, monotonic trends in PET values were determined by Spearman’s rho (SR), Mann-Kendall (MK), Şen slope (SS), and innovative trend analysis (ITA) tests and change points were analyzed with the sequential MK (SQMK) test. The Hargreaves equation was used to calculate the PET values. As a result of the study, according to MK and SR tests, while increasing trends at 95% and 99% significance levels were dominant at Erzincan and Bayburt stations, no statistically significant trends were found at Gümüşhane station except in February. ITA generally detected more than 5% increasing trends in PET data’s low, medium, and high values. According to ITA slope analysis, there are significant increase trends in PET values at all periods, trend 1% significance level. According to the SQMK test, it was revealed that the trend started in PET values, especially in 1995, 2005, and 2010. The findings emphasized the importance of taking measures against decreased agricultural production and managing water resources effectively.

PMID:37155102 | DOI:10.1007/s11356-023-27417-z

Environ Sci Pollut Res Int. 2023 May 8. doi: 10.1007/s11356-023-27383-6. Online ahead of print.

ABSTRACT

Many studies have incorporated particular models with various methods and algorithms to resolve the site selection problem for electric vehicle charging stations (EVCS). This paper systematically reviews research that evaluates geographic information systems (GIS) based EVCS location techniques and the variables used for decision making. We classify and characterize those techniques and variables to determine important linkages within the literature. A variety of databases were referenced to extract research published from 2010 to March 2023 pertinent to this specific location optimization problem, and 74 papers were selected after thorough evaluation. The models used in each paper were examined along with the methods for selecting variables and ranking alternate locations. Site selection for EVCS requires a multi-criteria decision making approach to meet the sustainability, efficiency, and performance goals of communities adopting electric vehicle mobility. Our results indicate that map algebra and data overlay methods have been used more frequently with GIS-based analysis than other techniques, while geographic and demographic variables are commonly the most significant site selection characteristics. The reviewed methods have most often been applied to urban locations; however, the transfer of these techniques to a rural EVCS site selection problem has been rarely explored in the current literature. This research assessment contributes relevant guidance for the application of methodologies useful in policymaking and provides recommendations for future research based on these findings.

PMID:37155094 | DOI:10.1007/s11356-023-27383-6

Environ Sci Pollut Res Int. 2023 May 8. doi: 10.1007/s11356-023-27286-6. Online ahead of print.

ABSTRACT

The increase in pathogen levels in seawater threatens the safety of entire aquatic ecosystems. Foodborne pathogens can potentially accumulate in shellfish, especially in filter feeders such as bivalves, requiring an efficient depuration process before consumption. Alternative approaches to promote a cost-efficient purge at depuration plants are urgently needed. A small prototype pulsed ultraviolet (PUV) light recirculation system was designed, and its depuration potential was tested in a seawater matrix artificially contaminated with high levels of microbial pathogens Escherichia coli, Staphylococcus aureus, Salmonella typhimurium, Bacillus cereus and Candida albicans. The analysis of treatment parameters including voltage, number of pulses and duration of treatment was performed to ensure the highest reduction in contaminant levels. Optimal PUV disinfection was attained at 60 pulses/min at 1 kV for 10 min (a UV output of 12.9 J/cm²). All reductions were statistically significant, and the greatest was observed for S. aureus (5.63 log₁₀), followed by C. albicans (5.15 log₁₀), S. typhimurium (5 log₁₀), B. cereus (4.59 log₁₀) and E. coli (4.55 log₁₀). PUV treatment disrupted the pathogen DNA with the result that S. aureus, C. albicans and S. typhimurium were not detectable by PCR. Regulations were reviewed to address the applicability of PUV treatment as a promising alternative to assist in the reduction of microbial pathogens at depuration plants due to its high efficiency, short treatment period, high UV dose and recirculation system as currently employed in shellfish depuration plants.

PMID:37155092 | DOI:10.1007/s11356-023-27286-6

Mol Biol Rep. 2023 May 8. doi: 10.1007/s11033-023-08364-x. Online ahead of print.

ABSTRACT

BACKGROUND: MiRNAs can affect the radiosensitization of head and neck squamous cell carcinoma (HNSCC). We aimed to analyze the function of miR-125 family members in HNSCC using The Cancer Genome Atlas (TCGA) and determine their effect on radiation in laryngeal squamous cell cancer (LSCC).

METHODS: First, we systematically analyzed the role of the miR-125 family in HNSCC using the TCGA database and found that miR-125a-5p is associated with radiotherapy. We then performed comprehensive enrichment analysis of miR-125a-5p and predicted target genes. Then, we performed transfection, cell proliferation assays, reverse transcription polymerase chain reaction, apoptosis assays, micronucleus tests, and western blotting on hep-2 cells selected with puromycin.

RESULTS: MiR-125 family members exhibited significantly different expression in HNSCC. They were significantly associated with tumor-node-metastasis staging, clinical stages, and histological grades. Radiation therapy had a statistically effect on miR-125 family members, except miR-125a-3p. Moreover, miR-125a-5p was related to overall survival in LSCC. Thus, we predicted 110 target genes and seven hub genes of miR-125a-5p. The proliferation rate of cells transfected with lentivirus vector expressing miR-125a-5p was significantly reduced compared to the other groups. The radiation effect was enhanced in cells transfected with miR-125a-5p. The ratio of apoptotic cells transfected and exposed to X-rays (10 Gy) was distinctly higher than that of the Ad-control group. Western blotting analysis revealed that miR-125a-5p upregulated the apoptotic regulators P53 and rH2AX. Thus, miR-125a-5p may increase radiosensitivity in LSCC via upregulation of pro-apoptotic genes.

CONCLUSIONS: MiR-125 family members could be prognostic biomarkers of HNSCC and improve HNSCC sensitivity to radiotherapy by activating P53. Upregulating miR-125a-5p via lentivirus vectors may be a novel strategy to strengthen the effect of radiotherapy on LSCC.

PMID:37155009 | DOI:10.1007/s11033-023-08364-x

Ir J Med Sci. 2023 May 8. doi: 10.1007/s11845-023-03386-7. Online ahead of print.

ABSTRACT

INTRODUCTION: The COVID-19 pandemic saw the migration of many physiotherapy-led group exercise programmes towards online platforms. This online survey aimed to ascertain the patients’ views of online group exercise programmes (OGEP), including their satisfaction with various aspects of these programmes, the advantages and disadvantages and usefulness beyond the pandemic.

METHODS: A mixed-methods design was utilised with a cross-sectional national online survey of patients who had previously attended a physiotherapy-led OGEP in Ireland. The survey collected both qualitative and quantitative data. Descriptive statistics were used to summarise the ordinal and continuous data and conventional content analysis was used to analyse the free-text responses.

RESULTS: In total, 94 patients completed the surveys. Fifty percent of patients questioned would prefer in-person classes. Despite only a quarter of patient respondents preferring online classes going forward, satisfaction with the OGEPs was high with nearly 95% of respondents somewhat or extremely satisfied. Decreased travel and convenience were cited as the main benefits of OGEPs. Decreased social interaction and decreased direct observation by the physiotherapist were the main disadvantages cited.

CONCLUSION: Patients expressed high satisfaction rates overall with online classes, but would value more opportunities for social interaction. Although 50% of respondents would choose in-person classes in the future, offering both online and in-person classes beyond the pandemic may help to suit the needs of all patients and improve attendance and adherence.

PMID:37154996 | DOI:10.1007/s11845-023-03386-7

Int Orthop. 2023 May 8. doi: 10.1007/s00264-023-05826-6. Online ahead of print.

ABSTRACT

PURPOSE: To analyze the risk factors of contralateral symptomatic foraminal stenosis (FS) after unilateral transforaminal lumbar interbody fusion (TLIF) and to guide and standardize the operation process of unilateral TLIF to reduce the occurrence of contralateral symptomatic FS.

METHODS: A retrospective study was undertaken on 487 patients with lumbar degeneration who underwent unilateral TLIF in the Department of Spinal Surgery of Ningbo Sixth Hospital between January 2017 and January 2021, comprising 269 males and 218 females, with a mean age of 57.1 years (range, 48-77 years). Cases of intraoperative improper operations, such as screw deviation, postoperative hematoma, and contralateral disc herniation, were excluded, and cases of nerve root symptoms caused by contralateral FS were analyzed. Post-surgery, 23 patients with nerve root symptoms caused by contralateral FS were categorized as group A, and 60 patients without nerve root symptoms were randomly selected as group B during the same period. The general data (gender, age, body mass index (BMI), bone mineral density (BMD), and diagnosis) and imaging parameters before and after operation (including contralateral foramen area (CFA), lumbar lordosis angle (LL), segmental lordosis angle (SL), disc height (DH), foramen height (FH), foramen width (FW), fusion cage position, and the difference between postoperative and preoperative) were compared between the two groups. Univariate analysis was performed, and multivariate analysis was undertaken through logistics analysis to determine the independent risk factors. Additionally, the clinical outcomes of the two groups were compared immediately before surgery and one year after surgery, using the visual analogue scale (VAS) score and the Japanese Orthopaedic Association (JOA) score for evaluation.

RESULTS: The patients in this study were followed up for a period of 19-25 (22.8atien months. Among them, 23 cases (4.72% incidence) were diagnosed with contralaterally symptomatic FS after the surgery. Univariate analysis indicated significant differences between the two groups in CFA, SL, FW, and cage coronal position. Logistic regression analysis identified preoperative contralateral foramen area (OR = 1.176, 95% CI (1.012, 1.367)), small segmental lordosis angle (OR = 2.225, 95% CI (1.124, 4.406)), small intervertebral foramen width (OR = 2.706, 95% CI (1.028, 7.118)), and cage coronal position not crossing the midline (OR = 1.567, 95% CI (1.142, 2.149)) as independent risk factors for contralateral symptomatic FS after unilateral TLIF. However, there was no statistically significant difference in the pain VAS score between the two groups one year after the operation. In contrast, there was a significant difference in the JOA score between the two groups.

CONCLUSION: The identified risk factors for contralateral symptomatic FS after TLIF include preoperative contralateral intervertebral foramen stenosis, a small segmental lordosis angle, a small intervertebral foramen width, and the coronal position of the cage not crossing the midline. For patients with these risk factors, it is recommended to carefully lock the screw rod during the recovery of lumbar lordosis and ensure that the coronal position of the fusion cage is implanted beyond the midline. If necessary, preventive decompression should also be considered. However, this study did not quantify the imaging data for each risk factor, and further research is needed to improve our understanding of the topic.

PMID:37154958 | DOI:10.1007/s00264-023-05826-6

Mamm Genome. 2023 May 8. doi: 10.1007/s00335-023-09993-0. Online ahead of print.

ABSTRACT

Experiments in which data are collected by multiple independent resources, including multicentre data, different laboratories within the same centre or with different operators, are challenging in design, data collection and interpretation. Indeed, inconsistent results across the resources are possible. In this paper, we propose a statistical solution for the problem of multi-resource consensus inferences when statistical results from different resources show variation in magnitude, directionality, and significance. Our proposed method allows combining the corrected p-values, effect sizes and the total number of centres into a global consensus score. We apply this method to obtain a consensus score for data collected by the International Mouse Phenotyping Consortium (IMPC) across 11 centres. We show the application of this method to detect sexual dimorphism in haematological data and discuss the suitability of the methodology.

PMID:37154937 | DOI:10.1007/s00335-023-09993-0

J Magn Reson Imaging. 2023 May 8. doi: 10.1002/jmri.28755. Online ahead of print.

ABSTRACT

BACKGROUND: The bone marrow (BM) evaluation of acute leukemia (AL) mainly depends on invasive BM puncture biopsy. Noninvasive and accurate MR examination technology has potential clinical application value in the BM evaluation of AL patients. Multi-gradient-echo (MGRE) has been found useful to evaluate changes in BM fat and iron content, but has not yet been applied in AL.

PURPOSE: To explore the diagnostic capability of BM infiltration of quantitative BM fat fraction (FF) and R2* values obtained from a 3D MGRE sequence in children with primary AL.

STUDY TYPE: Prospective.

POPULATION/SUBJECTS: Sixty-two pediatric patients with untreated AL and 68 healthy volunteers. AL patients were divided into acute lymphoblastic leukemia (ALL) (n = 39) and acute myeloid leukemia (AML) (n = 23) groups.

FIELD STRENGTH/SEQUENCE: 3T, 3D chemical-shift-encoded multi-gradient-echo, T1WI, T2WI, T2_STIR.

ASSESSMENT: BM FF and R2* values were assessed by manually drawing regions of interest at the L3, L4, ilium, and 1 cm below the bilateral trochanter of the femur (upper femur).

STATISTICAL TESTS: Independent sample t-tests, variance analysis, Spearman correlation.

RESULTS: BM FF and R2* at L3, L4, ilium, and upper femur, FF_total and R2*_total were significantly lower in the AL than control group. BM FF did not significantly differ between ALL and AML groups (P_L3 = 0.060, P_L4 = 0.086, P_ilium = 0.179, P_{upper femur} = 0.149, and P_totle = 0.097, respectively). The R2* was significantly lower in ALL group than AML group for L3, L4, and R2*_total . BM FF was moderately positively correlated with R2* in ALL group, and strongly positively correlated in AML group. Area under the receiver operating characteristic curves showed that BM FF had higher AUC in AL, ALL, and AML (all AUC = 1.000) than R2* (0.976, 0.996, and 0.941, respectively).

DATA CONCLUSION: MGRE-MRI mapping can be applied to measure BM FF and R2* values, and help evaluate BM infiltration and iron storage in children with AL.

EVIDENCE LEVEL: 1 Technical Efficacy: 2.

PMID:37154163 | DOI:10.1002/jmri.28755