Category: Nevin Manimala

J Sleep Res. 2022 Nov 27:e13795. doi: 10.1111/jsr.13795. Online ahead of print.

ABSTRACT

Recently an association between blood glucose dysregulation and sleep disruption was suggested. The association between sleep disordered breathing, most of which is due to obstructive sleep apnea (OSA) in the general population, and diabetic severity, as well as the impact of antidiabetic treatment, remains unclear. This study aimed to investigate these associations as well as age and sex differences. This cross-sectional study evaluated 7,680 community participants as the main cohort (population-based cohort). OSA was assessed by the 3% oxygen desaturation index from pulse oximetry, which was corrected for sleep duration obtained by wrist actigraphy. For arguing the limitations for using pulse oximetry, 597 hospitalised patients, who were assessed by the apnea-hypopnea index from attended polysomnography, were also evaluated as the validation cohort (hospital-based cohort). Moderate-to-severe OSA was more prevalent as haemoglobin A1c (HbA1c) levels increased (<5.6%/5.6%-<6.5%/6.5%-<7.5%/≥7.5%, respectively) in both cohorts (p < 0.001), but only in those without antidiabetic treatment. The HbA1c level was an independent factor for moderate-to-severe OSA (population-based cohort, odds ratio [OR] 1.26, 95% confidence interval [CI] 1.10-1.45; hospital-based cohort, OR 1.69, 95% CI 1.22-2.33, per 1% increase). These associations were more prominent in the middle-aged (aged <60 years) than in the elderly (aged ≥60 years) and in women than in men in both cohorts. The prevalence of moderate-to-severe OSA in patients with antidiabetic treatment in the hospital-based cohort was ≥75% regardless of HbA1c levels. In conclusion, an association between the prevalence of OSA and HbA1c level even within or over the normal range was found only in patients without antidiabetic treatment and was more prominent in the middle-aged and in women.

PMID:36437403 | DOI:10.1111/jsr.13795

Prog Orthod. 2022 Nov 28;23(1):43. doi: 10.1186/s40510-022-00438-z.

ABSTRACT

BACKGROUND: To assess the predictability of crowding resolution and the efficacy of different strategies to gain space during clear aligners treatment.

METHODS: A total of 10 clinicians were randomly recruited using the Doctor Locator by Align Technology (California). For each clinician, four consecutive patients treated with aligners and manual stripping were selected for a total of 40 subjects. Thus, 80 arches were collected and uploaded on the Orthoanalyzer software for arch measurements. The data were gained on the starting arch form (T0), on the virtual arch developed with digital planning (vT1), and on the arch form achieved at the end of the aligner sequences (T1). The following parameters were scored: Little’s Irregularity Index, transversal arch diameters, (intercuspid, interpremolar, and intermolar width), incisor position/arch length, and enamel interproximal reduction (IPR).

RESULTS: For all the measurements, statistically significant differences were found at different stages. The predictability of crowding resolution was very high, ranging from 87% in the upper arch and 81% in the lower one. Among the different strategies to gain space, variations in sagittal incisor position were predictable, with a value of 70% both in the upper and lower arch. Conversely, changes in arch diameters were less reliable varying between 49 and 67% in the lower arch and 59-83% in the upper one. Moreover, IPR was the least accurate procedure, wavering at 49% in the upper arch and 42% in the lower arch.

CONCLUSIONS: The predictability of crowding resolution during treatment with aligners was high. However, the virtual arch forms obtained at the end of digital planning (vT1) did not correspond with the arch forms at the end of the aligner sequences (T1). The IPR was the least predictable strategy to gain space, being, perhaps, an operator-dependent procedure.

PMID:36437397 | DOI:10.1186/s40510-022-00438-z

Int J Legal Med. 2022 Nov 28. doi: 10.1007/s00414-022-02920-z. Online ahead of print.

ABSTRACT

PURPOSE: Several studies tried to discuss and clarify the so-called Mellanby effect: Similar blood alcohol concentrations (BACs) supposedly lead to more signs of impairment in the phase of alcohol resorption than elimination. To assess this effect for alcoholised e-scooter driving, results of a real-driving fitness study were subanalysed.

METHODS: Sixteen subjects (9 females; 7 males) who completed runs at comparable BACs in the phases of alcohol resorption and elimination were chosen to assess a possible “Mellanby effect”. The data of the subjects was taken from a prior e-scooter study by Zube et al., which included 63 subjects in total.

RESULTS: In the phase of alcohol resorption, the relative driving performance was approx. 92% of the phase of elimination (p value 0.21). Statistically significant more demerits were allocated to the obstacle “narrowing track” in the phase of resorption than elimination. Subjects also needed significantly more time to pass the obstacles “narrowing track”, “driving in circles counterclockwise” and “thresholds” in the phase of resorption than elimination.

DISCUSSION: The most relevant obstacle to discriminate between the two different states of alcoholisation was the narrowing track. Insofar, measurements of the standard deviation of the lateral position (SDLP) might also be a sensitive component for the detection of central nervous driving impairment during shorter trips with an e-scooter. Additionally, driving slower during the phase of alcohol resorption seems to be the attempt to compensate alcohol-related deficits.

CONCLUSION: The results of the study suggest a slight Mellanby effect in e-scooter drivers.

PMID:36437382 | DOI:10.1007/s00414-022-02920-z

Bioprocess Biosyst Eng. 2022 Nov 28. doi: 10.1007/s00449-022-02819-4. Online ahead of print.

ABSTRACT

Consumer choice is typically influenced by color, leading to an increase in the use of artificial colorants by industry. However, several artificial colorants have been banned due to their harmful effects on human health and the environment, leading to increased interest in colorants from natural sources. Natural colorants can be found in plants, insects, and microorganisms. The importance of evaluating the technical and cost feasibility for the production of natural colorants are important factors for the replacement of artificial counterpart. Therefore, it is highly beneficial to predict the productivity of microbial colorants. The use of statistical methods that generate polynomial models through multiple regressions can provide information of interest about a bioprocess. However, modeling and control of biological processes require complex systems models, because they are nonlinear and non-deterministic systems. In this regard, artificial neural networks are suitable for estimating bioprocess variables with systems modeling. In this work, two different strategies were developed to predict the production of red colorants by Talaromyces amestolkiae, namely simulation by artificial neural networks (ANN) and response surface methodology (RSM). The results showed that the colorant concentration predicted by ANN is closer to the experimental data than that predicted by polynomial models fitted by multiple regression. Thus, this work suggests that the use of ANN can identify the initial conditions of the culture parameters that have the greatest influence on colorant production and can be a tool to be employed to improve the production of biotechnological products, such as microbial colorants.

PMID:36437377 | DOI:10.1007/s00449-022-02819-4

Pediatr Radiol. 2022 Nov 28. doi: 10.1007/s00247-022-05549-7. Online ahead of print.

ABSTRACT

BACKGROUND: The torcular pseudomass is an incidental extra-axial midline mass located between the venous sinuses and the occipital squama in the pediatric population. Although this structure is presumed to be a developmental feature, it has not been characterized on fetal MRI.

OBJECTIVE: To determine the frequency, imaging features and longitudinal in utero evolution of torcular pseudomass using fetal MRI.

MATERIALS AND METHODS: We present a single-center retrospective study of fetal MRI performed at a tertiary hospital. Two independent reviewers first ordinally scored torcular pseudomass as absent, focal, crescentic or bulky based on morphology. We reviewed available follow-up fetal and postnatal MRI and further classified torcular pseudomass as stable, involuted or progressive. We also collected clinical and demographic data from electronic charts and compared them among categories, corrected for multiple comparisons.

RESULTS: This study included a total of 219 fetuses with median gestational age of 28 weeks (interquartile range [IQR]: 23-32 weeks). Torcular pseudomass was absent in 8% (n=17) and present as a focal mass in 15% (n=33), crescentic in 45% (n=98) and bulky in 32% (n=71) of the cases. Median gestational age was statistically different among torcular pseudomass categories and inversely associated with size. Follow-up fetal MRI was available in 9.6% (n=21) of cases (median interval 4 weeks; IQR: 2-9 weeks) and torcular pseudomass in these cases was classified as stable in 67% (n=14), involuted in 29% (n=6) and progressive in 5% (n=1). Postnatal MRI was available in 5% (n=12) of fetuses (median interval 11.5 months, IQR: 3-17 months), and among these cases torcular pseudomass was classified as stable in 33% (n=4) and involuted in 67% (n=8).

CONCLUSION: Torcular pseudomass is highly prevalent in the fetal population and shows a natural tendency to involute, even in utero, although it sometimes persists during early infanthood.

PMID:36437371 | DOI:10.1007/s00247-022-05549-7

Sci Rep. 2022 Nov 27;12(1):20408. doi: 10.1038/s41598-022-24784-4.

ABSTRACT

Lumbar spinal stenosis (LSS) and sagittal imbalance are relatively common in elderly patients. Although the goals of surgery include both functional and radiological improvements, the criteria of correction may be too strict for elderly patients. If the main symptom of patients is not forward-stooping but neurogenic claudication or pain, lumbar decompression without adding fusion procedure may be a surgical option. We performed cost-utility analysis between lumbar decompression and lumbar fusion surgery for those patients. Elderly patients (age > 60 years) who underwent 1-2 levels lumbar fusion surgery (F-group, n = 31) or decompression surgery (D-group, n = 40) for LSS with sagittal imbalance (C7 sagittal vertical axis, C7-SVA > 40 mm) with follow-up ≥ 2 years were included. Clinical outcomes (Euro-Quality of Life-5 Dimensions, EQ-5D; Oswestry Disability Index, ODI; numerical rating score of pain on the back and leg, NRS-B and NRS-L) and radiological parameters (C7-SVA; lumbar lordosis, LL; the difference between pelvic incidence and lumbar lordosis, PI-LL; pelvic tilt, PT) were assessed. The quality-adjusted life year (QALY) and incremental cost-effective ratio (ICER) were calculated from a utility score of EQ-5D. Postoperatively, both groups attained clinical and radiological improvement in all parameters, but NRS-L was more improved in the F-group (p = 0.048). ICER of F-group over D-group was 49,833 US dollars/QALY. Cost-effective lumbar decompression may be a recommendable surgical option for certain elderly patients, despite less improvement of leg pain than with fusion surgery.

PMID:36437360 | DOI:10.1038/s41598-022-24784-4

Pharmacoeconomics. 2022 Nov 28. doi: 10.1007/s40273-022-01203-0. Online ahead of print.

ABSTRACT

Advanced health economic analysis techniques currently performed in Microsoft Excel, such as incorporating heterogeneity, time-dependent transitions and a value of information analysis, can be easily transferred to R. Often the outputs of survival analyses (such as Weibull regression models) will estimate the impacts of correlated patient characteristics on patient outcomes, and are utilised directly as inputs for health economic decision models. This tutorial provides a step-by-step guide of how to conduct such analyses with a Markov model developed in R, and offers a comparison with established analyses performed in Microsoft Excel. This is done through the conversion of a previously published Microsoft Excel case study of a hip replacement surgery cost-effectiveness model. We hope that this paper can act as a facilitator in switching decision models from Microsoft Excel to R for complex health economic analyses, providing open-access code and data, suitable for future adaptation.

PMID:36437359 | DOI:10.1007/s40273-022-01203-0

Sci Rep. 2022 Nov 27;12(1):20410. doi: 10.1038/s41598-022-24897-w.

ABSTRACT

China remains the largest nation of marine capture fisheries in the world in the last few decades, at the cost of offshore fisheries degradation by overfishing. Although fisheries regulations have become gradually tightened, the recovering evidences are weak and the catch species compositions are far from satisfactory. To explore better and reasonable countermeasures, besides the “zero growth” policy (i.e. the national total fisheries production limitation), five targets with different ecological traits were selected for stock assessment and rebuilding by Monte Carlo Catch-Maximum Sustainable Yield method. The results showed the control of total rather than species catch could not lead to the recovery of fisheries and maintain community function. Individual species showed different responses to overfishing according to their biological characteristics. High trophic level species can be sensitive to overfishing, and difficult to rebuild stocks after collapse. Pelagic small fish resources increased first but eventually decreased under high fishing pressure. Scientific-based restocking can enhance resource recovery. Besides “zero growth” policy, fisheries management should be further refined, in particular for main economic species based on their biological traits, as well as the support of reliable fisheries statistics and regulation implementation in place. To relieve the conflict between rising fishery products demand and falling catches, aquaculture and seeking resources from the high seas and EEZs are supposed to be successful ways, on the premise of taking full account of ecological health, maritime safety, and food security.

PMID:36437353 | DOI:10.1038/s41598-022-24897-w

Sci Rep. 2022 Nov 27;12(1):20392. doi: 10.1038/s41598-022-23259-w.

ABSTRACT

Chili (Capsicum annuum L.) and brinjal (Solanum melongena L.) are the most widely grown solanaceous crops in the world. However, their production has reduced over several years due to the attack of various fungal and bacterial pathogens and various abiotic factors. Still, the major constrain in their production are pathogens with fungal etiology, especially the fungal wilt of solanaceous crops. Fusarium oxysporum and Fusarium solani have been previously identified as the pathogens causing wilt disease in chili and brinjal. Recently, a new fungal pathogen F. equiseti has been reported as the causal agent of wilt disease infecting chili. The current study focused on identifying fungal pathogens associated with the wilted plants of chili and brinjal, collected from different parts of the Himalayan region of Kashmir valley, through morpho-cultural and molecular characterization. DNA extraction, PCR amplification, and sequencing were performed on various isolates. DNA barcoding using the internal transcribed spacer region (ITS) was used to identify the pathogen followed by the pathogenicity test. Further confirmation of the pathogen was done by sequencing of transcription elongation factor (TEF) and Calmodulin (CAL2). In current study Fusarium chlamydosporum has been reported as the wilt causing pathogen of chili and brinjal for the first time in Kashmir Himalayas.

PMID:36437280 | DOI:10.1038/s41598-022-23259-w

Sci Rep. 2022 Nov 27;12(1):20381. doi: 10.1038/s41598-022-24779-1.

ABSTRACT

The saturated hydraulic conductivity, k_sat, is a crucial variable to describe the hydromechanical behavior of soils. The value of k_sat of lateritic soils that are typically found in tropical regions is highly affected by the soil’s structure, void ratio, and fine particle aggregation. As a result, the determination of k_sat in the field or in the laboratory is complex and involves greater variability, depending on the type of test and on the spatial location of sampling. This paper presents a study of k_sat values of lateritic soils, analyzing them using Statistic, Multilayer Perceptron Artificial Neural Networks (ANN) and Decision Trees (CHAID). This study aims to support decision-making regarding the type of test and depth chosen for sampling in laterite soils and understanding the factors influencing the permeability of such soils. An extensive literature review on the k_sat values of lateritic soils was performed, providing data for the establishment of a database comprise of 722 registries. According to agronomic and geotechnical soil classifications, the Brazilian lateritic soils presents a “moderate” hydraulic conductivity. A significant variation of permeability values along the depth was identified, particularly for depths between 0.1 and 0.2 m. Regarding the importance of testing variables, the ANN indicated a high dependency on the type of test. The decision tree divided field test and laboratory test automatically, inferring the relevance of the type of test to the determination of k_sat.

PMID:36437279 | DOI:10.1038/s41598-022-24779-1