Category: Nevin Manimala

Knee Surg Sports Traumatol Arthrosc. 2022 Apr 16. doi: 10.1007/s00167-022-06967-8. Online ahead of print.

ABSTRACT

PURPOSE: Lateral meniscus posterior root tears (LMPRTs) are commonly found in patients with anterior cruciate ligament (ACL) injuries. However, risk factors for LMPRTs are not well known. This study was designed to systematically review the available evidence regarding risk factors associated with LMPRTs.

METHODS: The PubMed, EMBASE, Cochrane Library, and Web of Science databases were searched for papers containing the key words “lateral meniscus posterior root tears”, “LMPRTs” and “risk factor”. Inclusion screening, data extraction, and quality assessment of the included articles were conducted independently by two authors. Statistical analysis was conducted to determine risk factors for LMPRTs.

RESULT: Seventeen studies with a total sample size of 6, 589 patients were identified. The pooled prevalence of LMPRTs was 9.6% (range, 5.1-33.8%) for ACL injury. Significant risk factors included a patient age of < 30 [OR = 1.4, 95% CI (1.07, 1.84), p = 0.01], male sex [OR = 1.50, 95% CI (1.24,1.81), p = 0.01], higher body mass index (BMI) [MD = 0.45, 95% CI (0.13, 0.76), p < 0.01], higher lateral posterior tibial slope (LPTS) [MD = 2.22, 95% CI (1.37, 3.07), p < 0.01], deep sulcus sign [OR = 5.76, 95% CI (1.35, 24.52), p < 0.01] and bone bruises on lateral femoral condyle [OR = 4.88, 95% CI (1.27, 18.77), p < 0.01], lateral meniscal extrusion > 1 mm [OR = 5.56, 95% CI (1.52, 20.29), p < 0.01] and > 3 mm [OR = 12.91 95% CI (1.28, 130.01), p < 0.01], medial meniscal tears [OR = 1.40, 95% CI (1.12, 1.75), p < 0.01], and medial ramp lesions [OR = 2.29, 95% CI (1.35, 3.89), p < 0.01].

CONCLUSION: Age below 30, male, higher BMI, higher LPTS, deep sulcus sign, bone bruises on lateral femoral condyle, lateral meniscal extrusion, medial meniscal tear, and medial ramp lesion are risk factors for LMPRTs.

LEVEL OF EVIDENCE: Level IV.

PMID:35429241 | DOI:10.1007/s00167-022-06967-8

Diagn Cytopathol. 2022 Apr 16. doi: 10.1002/dc.24965. Online ahead of print.

ABSTRACT

OBJECTIVE: This study has been designed in an effort to identify the clinico-radiological and cytological features that could effectively help in differentiating cellular fibroadenoma (CFA) and phyllodes tumors (PT), which have several overlapping characteristics.

METHOD: Histologically proven cases of CFA and PT were reviewed. Cytological features were assessed and categorized. Clinical and radiological details were also evaluated and he the two groups were compared statistically.

RESULTS: A total of 43 FA and 52 PT were specimens were reviewed. Mean age and tumor size for CFA and PT were 26.05 and 36.94 years, and 3.7 and 6.4 cm, respectively. Univariate analysis and regression models revealed that age >30 years, BIRADS grade of 4 or more, marked cellularity of stromal fragments, more than 30% spindle cells in background cell population and presence of traversing blood vessels in stromal fragments increased the odds of a tumor being phyllodes. The binary logistic regression model was able to predict PT accurately in 87.2% cases (p < .001).

CONCLUSION: PT and CFA could be differentiated if cytological findings are cautiously correlated clinically and radiologically. Age, BIRADS category along with assessment of stromal fragments and background population can effectively distinguish between CFA and PT.

PMID:35429232 | DOI:10.1002/dc.24965

Glob Chang Biol. 2022 Apr 16. doi: 10.1111/gcb.16201. Online ahead of print.

ABSTRACT

The dominance of vapor pressure deficit (VPD) and soil water content (SWC) for plant water stress is still under debate. These two variables are strongly coupled and influenced by climatic drivers. The impacts of climatic drivers on the relationships between gross primary production (GPP) and water stress from VPD/SWC and the interaction between VPD and SWC are not fully understood. Here, applying statistical methods and extreme gradient boosting models-Shapley additive explanations framework to eddy-covariance observations from the global FLUXNET2015 dataset, we found that the VPD-GPP relationship was strongly influenced by climatic interactions, and that VPD was more important for plant water stress than SWC across most plant functional types when we removed the effect of main climatic drivers, e.g. air temperature, incoming shortwave radiation and wind speed. However, we found no evidence for a significant influence of elevated CO₂ on stress alleviation, possibly because of the short duration of the records (approximately one decade). Additionally, the interactive effect between VPD and SWC differed from their individual effect. When SWC was high, the SHAP interaction value of SWC and VPD on GPP was decreased with increasing VPD, but when SWC was low, the trend was the opposite. Additionally, we revealed a threshold effect for VPD stress on GPP loss; above the threshold value, the stress on GPP was flattened off. Our results have important implications for independently identifying VPD and SWC limitations on plant productivity, which is meaningful for capturing the magnitude of ecosystem responses to water stress in dynamic global vegetation models.

PMID:35429206 | DOI:10.1111/gcb.16201

J Magn Reson Imaging. 2022 Apr 16. doi: 10.1002/jmri.28204. Online ahead of print.

ABSTRACT

BACKGROUND: There is an overlap comparing transition zone prostate cancer (TZ PCa) and benign prostatic hyperplasia (BPH) on T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI), creating additional challenges for assessment of TZ tumors on MRI.

PURPOSE: To evaluate whether amide proton transfer-weighted (APTw) imaging provides new diagnostic ideas for TZ PCa.

STUDY TYPE: Prospective.

POPULATION: A total of 51 TZ PCa patients (age, 49-89), 44 stromal BPH (age, 57-92), and 45 glandular BPH patients (age, 56-92).

FIELD STRENGTH/SEQUENCE: A 3 T; T2WI turbo spin echo (TSE), quantitative T2*-weighted imaging, DWI echo planar imaging, 3D APTw TSE.

ASSESSMENT: Differences in APTw, apparent diffusion coefficient (ADC), and T2* among three lesions were compared by one-way analysis of variance (ANOVA). Regions of interest were drawn by two radiologists (X.Q.Z. and X.Y.Q., with 21 and 15 years of experience, respectively).

STATISTICAL TESTS: Multivariable logistic regression analyses; ANOVA with post hoc testing; receiver operator characteristic curve analysis; Delong test. Significance level: P < 0.05.

RESULTS: APTw among TZ PCa, stromal BPH, and glandular BPH (3.48% ± 0.83% vs. 2.76% ± 0.49% vs. 2.72% ± 0.45%, respectively) were significantly different except between stromal BPH and glandular BPH (P > 0.99). Significant differences were found in ADC (TZ PCa 0.76 ± 0.16 × 10^-3 mm² /sec vs. stromal BPH 0.91 ± 0.14 × 10^-3 mm² /sec vs. glandular BPH 1.08 ± 0.18 × 10^-3 mm² /sec) among three lesions. APTw (OR = 12.18, 11.80, respectively) and 1/ADC (OR = 703.87, 181.11, respectively) were independent predictors of TZ PCa from BPH and stromal BPH. The combination of APTw and ADC had better diagnostic performance in the identification of TZ PCa from BPH and stromal BPH.

DATA CONCLUSION: APTw imaging has the potential to be of added value to ADC in differentiating TZ PCa from BPH and stromal BPH.

EVIDENCE LEVEL: 2 TECHNICAL EFFICACY: Stage 2.

PMID:35429190 | DOI:10.1002/jmri.28204

J Appl Clin Med Phys. 2022 Apr 15:e13602. doi: 10.1002/acm2.13602. Online ahead of print.

ABSTRACT

PURPOSE: The EPID PSM is a useful EPID calibration method for QA applications. The dependence of the EPID PSM on the photon beam used to acquire it has been investigated in this study for the four available PSM methods. The aim is to inform upon the viability of applying a single PSM for all available photon beams to simplify PSM implementation and maintenance.

METHODS: Four methods of PSM determination were each measured once in a single session on a single TrueBeam ® STx linac using 6 MV, 10 MV, 6 MV Flattening-Filter-Free (FFF), and 10 MV FFF photon beams. The resultant PSM was assessed for both intra- and inter-method beam dependence via comparison between PSM of the same method compared to the 6 MV PSM and via comparison between PSM of the same beam with the corresponding Monte Carlo PSM. Comparisons were performed via 2D percentage deviation plots with associated histograms, 1D crossplane profiles, and via mean, median, and standard deviation percentage deviation statistics. Generated beam-response was compared qualitatively via 1D crossplane profile comparison and quantitatively via symmetry assessment with comparison to the IC profiler device.

RESULTS: The Varian method provided the most consistent PSM with varying photon beam, with median percent deviation from the 6 MV PSM within 0.14% for all other beams. Qualitatively, each method provided similar beam-response profiles. The measured beam-response symmetry agreed to within 0.2% between the Calvary Mater Newcastle (CMN) method and IC profiler, but agreement reduced to within 0.9% and 2.2% for the Varian and WashU methods. PSM percent deviation with Monte Carlo PSM was within 0.75% for all methods and beams.

CONCLUSION: Results suggest that the PSM may be independent of photon beam to clinically relevant levels. The Varian method of PSM determination introduces the least beam dependence into the measured PSM.

PMID:35429117 | DOI:10.1002/acm2.13602

Integr Environ Assess Manag. 2022 Apr 16. doi: 10.1002/ieam.4620. Online ahead of print.

ABSTRACT

According to the latest projections of the IPCC, at the end of the century, coastal zones and low-lying ecosystems will be increasingly threatened by rising global mean sea levels. In order to support integrated coastal zone management and advance the basic “source-pathway-receptor-consequence” approach focused on traditional receptors (e.g. population, infrastructure, economy), a novel risk framework is proposed able to evaluate potential risks of loss or degradation of ecosystem services (ESs) due to projected extreme sea level scenarios in the Italian coast. Three risk scenarios for the reference period (1969-2010) and future time frame up to 2050 under RCP4.5 and RCP8.5 are developed by integrating extreme water-level projections related to changing climate conditions, with vulnerability information about the topography, distance from coastlines, and presence of artificial protections. A risk assessment is then performed considering the potential effects of the spatial-temporal variability of inundations and land use on the supply level and spatial distribution of ESs. The results of the analysis are summarized into a spatially-explicit risk index, useful to rank coastal areas more prone to ESs losses or degradation due to coastal inundation at the national scale. Overall, the Northern Adriatic coast is scored at high risk of ESs loss or degradation in the future scenario. Other small coastal strips with medium risk scores are the Eastern Puglia coast, Western Sardinia, and Tuscany’s coast. The ESs coastal risk index provides an easy-to-understand screening assessment that could support the prioritization of areas for coastal adaptation at the national scale. Moreover, this index allows the direct evaluation of the public value of ecosystems and supports more effective territorial planning and environmental management decisions. In particular, it could support the mainstreaming of ecosystem-based approaches (e.g. ecological engineering, green infrastructures) to mitigate the risks of climate change and extreme events while protecting ecosystems and biodiversity. This article is protected by copyright. All rights reserved.© 2022 Society of Environmental Toxicology & Chemistry (SETAC).

PMID:35429140 | DOI:10.1002/ieam.4620

Biom J. 2022 Apr;64(4):771-804. doi: 10.1002/bimj.202000036. Epub 2022 Jan 23.

ABSTRACT

With the progressive technology, many medical researches are aimed to develop diagnostic tests that can detect diseases faster and accurately. The assessment of the accuracy of the diagnostic test for classifying two groups is through the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC). When a paired design is considered, the sample size determination requires the information about two AUC estimates and the corresponding variance and covariance of two AUC estimators. This paper derives the nonparametric estimators of the variance and covariance of two AUC estimators. The result is used to derive the sample size formula when the paired sample is planned. Since most of the results do not have a closed form, numerical results are provided under various scenarios.

PMID:35429054 | DOI:10.1002/bimj.202000036

J Adv Nurs. 2022 Apr 15. doi: 10.1111/jan.15249. Online ahead of print.

ABSTRACT

AIMS: To investigate Group B Streptococcus (GBS) colonization in pregnancy; adherence to antenatal GBS screening and adherence to the intrapartum antibiotics protocol within two models of care (midwifery and non-midwifery led).

DESIGN: This retrospective quantitative study has employed a descriptive design using administrative health data.

METHODS: Data from five maternity hospitals in metropolitan and regional Western Australia that included 22,417 pregnant women who gave birth between 2015 and 2019 were examined, applying descriptive statistics using secondary data analysis.

RESULTS: The study revealed an overall GBS colonization rate of 21.7% with similar rates in the different cohorts. A lower adherence to screening was found in the midwifery led model of care (MMC, 68.76%, n = 7232) when compared with the non-midwifery led model of care (NMMC, 90.49%, n = 10,767). Over the 5 years, screening rates trended down in the MMC with stable numbers in the counterpart. Adherence in relation to intrapartum antibiotic prophylaxis revealed discrepant findings between the study groups.

CONCLUSION: Adherence to screening and management guidelines of maternal GBS colonization in pregnancy is lower within the MMC when compared with the NMMC.

IMPACT: This is the first cohort study to describe the adherence to the recommended Western Australian GBS screening guidelines in the two different models of care. Findings may assist in the guidance and improvement of clinical protocols as well as the planning of clinical care in relation to GBS screening to reduce the risk of neonatal GBS infection.

PMID:35429021 | DOI:10.1111/jan.15249

Biom J. 2022 Apr 15. doi: 10.1002/bimj.202100231. Online ahead of print.

ABSTRACT

Abundance estimation from capture-recapture data is of great importance in many disciplines. Analysis of capture-recapture data is often complicated by the existence of one-inflation and heterogeneity problems. Simultaneously taking these issues into account, existing abundance estimation methods are usually constructed on the basis of conditional likelihood under one-inflated zero-truncated count models. However, the resulting Horvitz-Thompson-type estimators may be unstable, and the resulting Wald-type confidence intervals may exhibit severe undercoverage. In this paper, we propose a semiparametric empirical likelihood (EL) approach to abundance estimation under one-inflated binomial and Poisson regression models. To facilitate the computation of the EL method, we develop an expectation-maximization algorithm. We also propose a new score test for the existence of one-inflation and prove its asymptotic normality. Our simulation studies indicate that compared with existing estimators, the proposed score test is more powerful and the maximum EL estimator has a smaller mean square error. The advantages of our approaches are further demonstrated by analyses of prinia data from Hong Kong and drug user data from Bangkok.

PMID:35429047 | DOI:10.1002/bimj.202100231

Eur Geriatr Med. 2022 Apr 15. doi: 10.1007/s41999-022-00644-2. Online ahead of print.

ABSTRACT

PURPOSE: Geriatrician numbers are increasing year by year in Turkey. We aimed to obtain information on licensed geriatricians, trainees, and board of directors of the societies in Turkey and compare this information with other countries’ data.

METHODS: The study was conducted as a cross-sectional study. The gender, institution, and title of licensed geriatricians and trainees were documented by scanning websites of university, training and research, state hospitals, and the website of Academic Geriatrics Association. Information about the board of directors of the societies was obtained from the websites of the societies. The last day for data inclusion was August 31, 2021.

RESULTS: There were 90 licensed geriatricians and 77 trainees in Turkey as of 31 August 2021. While 52.2% (n = 47) of licensed geriatricians were female, the ratio of females among trainees was 76.6% (n = 59). The ratio of females among trainees was statistically higher than licensed geriatricians (p = 0.001). Females constitute 88.9% of the board of directors of the Academic Geriatrics Association and this ratio was higher than the ratio of females on the board of directors of local and international journals.

CONCLUSION: Best of our knowledge, our study is the first to examine the gender distribution in geriatrics. The dominance of females in geriatrics is very important in countries where geriatrics is relatively newly established as even countries with a deep-rooted history and structure in geriatrics are trying to increase the number of female geriatricians under their new administrations.

PMID:35428970 | DOI:10.1007/s41999-022-00644-2