Category: Nevin Manimala

J Neurosurg Spine. 2022 Dec 16:1-7. doi: 10.3171/2022.10.SPINE22381. Online ahead of print.

ABSTRACT

OBJECTIVE: Posterior cervical fusion is a common surgical treatment for patients with myeloradiculopathy or regional deformity. Several studies have found increased stresses at the cervicothoracic junction (CTJ) and significantly higher revision surgery rates in multilevel cervical constructs that terminate at C7. The purpose of this study was to investigate the biomechanical effects of selecting C7 versus T1 versus T2 as the lowest instrumented vertebra (LIV) in multisegmental posterior cervicothoracic fusion procedures.

METHODS: Seven fresh-frozen cadaveric cervicothoracic spines (C2-L1) with ribs intact were tested. After analysis of the intact specimens, posterior rods and lateral mass screws were sequentially added to create the following constructs: C3-7 fixation, C3-T1 fixation, and C3-T2 fixation. In vitro flexibility tests were performed to determine the range of motion (ROM) of each group in flexion-extension (FE), lateral bending (LB), and axial rotation (AR), and to measure intradiscal pressure of the distal adjacent level (DAL).

RESULTS: In FE, selecting C7 as the LIV instead of crossing the CTJ resulted in the greatest increase in ROM (2.54°) and pressure (29.57 pound-force per square inch [psi]) at the DAL in the construct relative to the intact specimen. In LB, selecting T1 as the LIV resulted in the greatest increase in motion (0.78°) and the lowest increase in pressure (3.51 psi) at the DAL relative to intact spines. In AR, selecting T2 as the LIV resulted in the greatest increase in motion (0.20°) at the DAL, while selecting T1 as the LIV resulted in the greatest increase in pressure (8.28 psi) in constructs relative to intact specimens. Although these trends did not reach statistical significance, the observed differences were most apparent in FE, where crossing the CTJ resulted in less motion and lower intradiscal pressures at the DAL.

CONCLUSIONS: The present biomechanical cadaveric study demonstrated that a cervical posterior fixation construct with its LIV crossing the CTJ produces less stress in its distal adjacent discs compared with constructs with C7 as the LIV. Future clinical testing is necessary to determine the impact of this finding on patient outcomes.

PMID:36681959 | DOI:10.3171/2022.10.SPINE22381

Brief Bioinform. 2023 Jan 21:bbad006. doi: 10.1093/bib/bbad006. Online ahead of print.

ABSTRACT

Single-cell RNA-seq enabled in-depth study on tissue micro-environment and immune-profiling, where a crucial step is to annotate cell identity. Immune cells play key roles in many diseases, whereas their activities are hard to track due to their diverse and highly variable nature. Existing cell-type identifiers had limited performance for this purpose. We present HiCAT, a hierarchical, marker-based cell-type identifier utilising gene set analysis for statistical scoring for given markers. It features successive identification of major-type, minor-type and subsets utilising subset markers structured in a three-level taxonomy tree. Comparison with manual annotation and pairwise match test showed HiCAT outperforms others in major- and minor-type identification. For subsets, we qualitatively evaluated the marker expression profile demonstrating that HiCAT provide the clearest immune-cell landscape. HiCAT was also used for immune-cell profiling in ulcerative colitis and discovered distinct features of the disease in macrophage and T-cell subsets that could not be identified previously.

PMID:36681937 | DOI:10.1093/bib/bbad006

J Immunoassay Immunochem. 2023 Jan 22:1-13. doi: 10.1080/15321819.2023.2168557. Online ahead of print.

ABSTRACT

Alopecia areata (AA) is a disorder with several etiologies. The evidence suggests that the absolute copy number of mitochondrial deoxyribonucleic acid (mtDNA), as well as proportion of mutated mtDNA copies, determines disease onset. This study aims to quantify the relative index of the mtDNA copy number in patients with AA and healthy controls and correlate the results with the existing clinical ‎information. This case-control study included 50 patients with AA and 50 age- and sex-coordinated healthy persons as controls. The severity of AA was weighed using the Severity of Alopecia Tool and Kavak’s classification. The relative index of the mtDNA copy number was measured by real-time qPCR. Significant statistical difference was observed between cases and controls regarding mean mtDNA copy number, p < .001. There was significant positive correlation with SALT score (p = 0.001). A cutoff value of >1.619 N/µL could significantly diagnose AA cases (p < .001), and a cutoff value of > 1.36 N/µL could discriminate mild AA cases from those with moderate AA (p = 0.007). The relative index of mtDNA copy number is significantly elevated in AA cases and could be helpful in diagnosing and evaluating AA severity.

PMID:36681933 | DOI:10.1080/15321819.2023.2168557

Clin Exp Hypertens. 2023 Dec 31;45(1):2169452. doi: 10.1080/10641963.2023.2169452.

ABSTRACT

PURPOSE: To determine the effect of auricular acupuncture on preoperative blood pressure (BP) elevation in different age groups.

MATERIALS AND METHODS: Auricular acupuncture treats elevated BP among patients before surgery. This prospective, randomized clinical trial was performed at Li Huili Hospital of Ningbo Medical Center, China, from January to June 2021. We prospectively enrolled 120 patients with elevated BP aged 45 to 75 and observed them in the inpatient department. Patients were randomly assigned in a 1:1 ratio to undergo auricular acupuncture or sham control groups. In addition to usual care, the study group underwent auricular acupuncture bilaterally at HX6 7i-Ear apex, TF4-Shen men, TF1-Superior triangular fossa, and CO15-Heart.

RESULTS: A total of 120 patients completed the study, 60 in the study group and 60 in the control group. Of these, 76 (63.3%) were men, and the mean (standard deviation) was 64.55 (9.48) years. The differences in systolic BP comparisons after intervention were significant (7.88 mmHg; 95% confidence interval [CI], 2.94 to 12.81; P = .002). Diastolic BP also showed statistical significance (5.85 mmHg; 95% CI, 3.05 to 8.64; P < .01. Neither AA-related adverse events nor serious adverse events occurred. Stratified by age, the differences comparisons of systolic BP (-10.13 mmHg; 95% confidence interval [CI], -16.69 to -3.57; P < .01) and diastolic BP (-7.65 mmHg; 95% confidence interval [CI], -11.17 to -4.14; P < .01) were statistically significant for participants aged 60-75 years; The differences comparison of systolic BP (-2.37 mmHg; 95% confidence interval [CI], -8.04 to 3.31; P = .40) and diastolic BP (-1.46 mmHg; 95% confidence interval [CI], -5.68 to 2.76; P = .48) were not significant aged 45-59.

CONCLUSION: Auricular acupuncture can reduce BP before procedures. However, further research is needed on the antihypertensive effect on people aged 45-59. These findings provide clinicians with evidence of auricular acupuncture as a standard adjunctive therapy targeting this patient population.

PMID:36681906 | DOI:10.1080/10641963.2023.2169452

Brief Bioinform. 2023 Jan 21:bbad014. doi: 10.1093/bib/bbad014. Online ahead of print.

ABSTRACT

Identification of potential targets for known bioactive compounds and novel synthetic analogs is of considerable significance. In silico target fishing (TF) has become an alternative strategy because of the expensive and laborious wet-lab experiments, explosive growth of bioactivity data and rapid development of high-throughput technologies. However, these TF methods are based on different algorithms, molecular representations and training datasets, which may lead to different results when predicting the same query molecules. This can be confusing for practitioners in practical applications. Therefore, this study systematically evaluated nine popular ligand-based TF methods based on target and ligand-target pair statistical strategies, which will help practitioners make choices among multiple TF methods. The evaluation results showed that SwissTargetPrediction was the best method to produce the most reliable predictions while enriching more targets. High-recall similarity ensemble approach (SEA) was able to find real targets for more compounds compared with other TF methods. Therefore, SwissTargetPrediction and SEA can be considered as primary selection methods in future studies. In addition, the results showed that k = 5 was the optimal number of experimental candidate targets. Finally, a novel ensemble TF method based on consensus voting is proposed to improve the prediction performance. The precision of the ensemble TF method outperforms the individual TF method, indicating that the ensemble TF method can more effectively identify real targets within a given top-k threshold. The results of this study can be used as a reference to guide practitioners in selecting the most effective methods in computational drug discovery.

PMID:36681902 | DOI:10.1093/bib/bbad014

Epilepsia. 2023 Jan 22. doi: 10.1111/epi.17516. Online ahead of print.

ABSTRACT

OBJECTIVE: There are no clinical guidelines dedicated to the treatment of epilepsy in older adults. We investigated physician opinion and practice regarding the treatment of people with epilepsy aged 65 years or older. We also sought to study how our opinion and practice varied between geriatricians, general neurologists, and epilepsy neurologists (i.e. epileptologists).

METHODS: We initially piloted our survey to measure test-retest reliability. Once finalized, we disseminated the survey via two rounds of facsimiles, and then conventional mail, to eligible individuals listed in a national directory of Canadian physicians. We used descriptive statistics such as stacked bar charts and tables to illustrate our findings.

RESULTS: One hundred and forty-four physicians [104 general neurologists, 25 geriatricians, and 15 epileptologists] answered our survey in its entirety (overall response rate of 13.2%). Levetiracetam and lamotrigine were the preferred antiseizure medications (ASMs) to treat older adults with epilepsy. Two thirds of epileptologists and almost half of general neurologists would consider prescribing lacosamide in >50% of people aged over 65 years; only one geriatrician was of the same opinion. More than 40% of general neurologists and geriatricians erroneously believed that none of the ASMs mentioned in our survey were previously studied in randomized controlled trials specific to the treatment of epilepsy in older adults. Epileptologists were more likely as compared to general neurologists and geriatricians to recommend epilepsy surgery (e.g. 66.6% versus 22.9 to 37.5% among older adults).

SIGNIFICANCE: Therapeutic decisions for older adults with epilepsy are heterogeneous between physician groups and sometimes misalign with available clinical evidence. Our surveyed physicians differed in their approach to ASM choice as well as perception about surgery in older adults with epilepsy. These findings likely reflect the lack of clinical guidelines dedicated to this population and the deficient implementation of best practices.

PMID:36681893 | DOI:10.1111/epi.17516

NMR Biomed. 2023 Jan 21:e4910. doi: 10.1002/nbm.4910. Online ahead of print.

ABSTRACT

Neurochemical concentrations determined by magnetic resonance spectroscopy (MRS) have been treated as statistically independent measurements in various clinical MRS studies. However, spectral overlap, independent of any biological effects, could lead to significant correlations between neurochemical concentrations extracted from spectral fitting of MRS data, confounding determination of correlations of biological origin. Short echo time (TE) proton MRS spectra are very crowded due to the relatively narrow chemical shift dispersion of proton nuclear spins. In this study, the complex neurochemical correlations of spectral origin in short-TE MRS spectra were quantified. The effects of macromolecules and the background spectral baseline on metabolite-metabolite correlations were also analyzed. These results demonstrate the importance of factoring in spectral correlations when correlating overlapping metabolite signals in short-TE spectra with clinical parameters.

PMID:36681860 | DOI:10.1002/nbm.4910

J Gastroenterol Hepatol. 2023 Jan 21. doi: 10.1111/jgh.16132. Online ahead of print.

ABSTRACT

BACKGROUNDS: Antiviral therapy (AVT) is the mainstay of hepatitis B virus (HBV) management. We investigated whether AVT improves the outcomes of HBV-related decompensated cirrhosis and undetectable HBV DNA.

METHODS: Between 2000 and 2017, treatment-naïve patients with HBV-related decompensated cirrhosis and undetectable HBV DNA were recruited from two tertiary hospitals. The endpoints included death and hepatocellular carcinoma (HCC).

RESULTS: A total of 429 patients were analyzed (50 and 379 patients in the AVT and Non-AVT groups, respectively). Patients in the AVT group were significantly younger and had higher alanine aminotransferase and alpha-fetoprotein levels than those in the non-AVT group (all P<0.05). During follow-up (median 49.6 months), 98 patients died and 105 developed HCC. The cumulative incidence rates of death (2.0%, 4.1%, and 6.4%, and 4.9%, 7.2%, and 10.2% at 6 months, 1 and 2 years, respectively) and HCC (8.6%, 15.8%, and 26.4% vs. 1.6%, 7.7%, and 24.4% at 1, 2, and 5 years, respectively) were statistically comparable between AVT and non-AVT groups (all P>0.05). Using Cox regression analysis, AVT was not significantly associated with death nor HCC (all P>0.05). Similar results were observed after balancing baseline characteristics with IPTW. In non-AVT group, the cumulative incidence rate of HBV DNA detection at 6 months, 1 and 2 years were 2.0%, 3.1%, and 6.4%, respectively.

CONCLUSIONS: AVT did not attenuate the risk of death nor HCC in patients with HBV-related decompensated cirrhosis and undetectable HBV DNA.

PMID:36681856 | DOI:10.1111/jgh.16132

BMC Med Educ. 2023 Jan 21;23(1):48. doi: 10.1186/s12909-023-04028-3.

ABSTRACT

BACKGROUND: Case-based learning (CBL) is an effective teaching-learning strategy that provides a learning environment similar to actual practice. The aim of the present study was to determine the nursing student’s satisfaction with two methods of CBL and lecture-based learning.

METHODS: This descriptive observational study was conducted in 2019 in School of Nursing and Midwifery in Ilam. All 128 undergraduate nursing students in the 3rd, 4th, and 5th semesters of nursing were enrolled in the study to compare students’ satisfaction with CBL and lecture-based learning. Data collection tools included a demographic information questionnaire and a researcher-made questionnaire consisting of 20 questions based on the Likert scale. Data analysis was performed using SPSS Statistics 22.

RESULTS: More than two thirds of the students (81.3%) found the CBL method was better than lectures. 60% of male students and 62% of female students stated that the CBL method increased their self-confidence compared to the traditional lecture-based learning (p < 0.03). Students were very satisfied with the CBL method (9.1 ± 1.1 out of 10). There was no significant relationship between gender-related features, and the mean score of students’ satisfaction with the CBL method (p > 0.05). However, 4th semester students were more satisfied than other students (P = 0.02).

CONCLUSION: The results show that CBL, as a teaching-learning technique in specialized nursing courses, increases students’ satisfaction and self-confidence compared to lecture.

PMID:36681853 | DOI:10.1186/s12909-023-04028-3

BMC Nurs. 2023 Jan 21;22(1):20. doi: 10.1186/s12912-023-01175-2.

ABSTRACT

BACKGROUND: Preoperative teaching practice is very important to surgical clients in freeing them from anxiety and post-operative complications. The preoperative education received by the patients depends on the knowledge and experience of nurses. The diversity in the degree of knowledge and experience possessed by nurses may result in inadequate and ineffective preoperative preparation of patients. Therefore, this study aimed to assess the knowledge, practice, and associated factors of preoperative patient teaching among nurses working at surgical units in Northwest Amhara Comprehensive Specialized Referral Hospitals, Northwest Ethiopia, 2022.

METHOD: An institutional-based cross-sectional study triangulated with a qualitative approach was conducted from April to June 2022. The data were collected using a semi-structured self-administered questionnaire and in-depth interviews. The descriptive statistics were presented in text and tables. Analytical analysis schemes including bivariable and multivariable logistic regression were computed considering P-value < 0.05 to identify statistically significant factors. Qualitative data were analyzed with thematic analysis.

RESULT: A total of 406 participants were involved in this study with a 95.8% response rate. The adequate knowledge of nurses was 61.6% with 95% CI: (56.7, 66.3) and significantly associated with being male, nurse use of guidelines, nurses they have been trained, and nurses’ who say they do not a staff shortage had good knowledge than the counterparts. Good practice of nurses regarding preoperative patient education was 46.3% with 95% CI (41.4, 51.0) significantly associated with the presence of preoperative teaching guidelines, took training on patient education, nurses who said no staff shortage, and knowledge of preoperative patient education.. Nurses have a positive interaction with the patient and much work experience had good practice but lack of training; inadequate supplies and lack of professional prerequisites are some of the barriers identified.

CONCLUSION: Nurses’ knowledge and practice regarding preoperative patient teaching were found to be inadequate. So, it is better to strengthen training, adequate staffing, equip wards with standardized guidelines and teaching materials, motivate and create a safe working environment. Most nurses explore factors of preoperative patients’ teaching as institutional, Nurse’s related, and patient-related factors.

PMID:36681844 | DOI:10.1186/s12912-023-01175-2