Category: Nevin Manimala

Ann N Y Acad Sci. 2022 Feb 24. doi: 10.1111/nyas.14746. Online ahead of print.

ABSTRACT

Statistics plays a key role in many areas of modern society, including technology, social and behavior studies, economics, and the sciences. Statistics anxiety (SA) has a detrimental impact on academic experiences in university populations, although the mediating factors remain underexplored. We conducted the first systematic review and meta-analysis focused on SA in university students in the context of statistical performance, individual differences in statistical learning, self-perceptions regarding the statistics course and instructor, and sociodemographic factors. Searches were carried out in the PsycINFO, PubMed, Scielo, and Web of Science databases according to our preregistration. Forty studies were selected for systematic review. Seventeen were included in a series of six meta-analyses concerning academic achievement, attitudes, self-perception, procrastination, and gender. The findings reveal learning strategies, procrastination, self-efficacy, and self-awareness as predictors of SA. However, the impact of sociodemographic data in these moderators is still uncharted. We conclude with a critical appraisal of the selected studies and present future directions for research in SA.

PMID:35211989 | DOI:10.1111/nyas.14746

Rofo. 2022 Feb 24. doi: 10.1055/a-1740-4310. Online ahead of print.

ABSTRACT

PURPOSE: Classifications were created to facilitate radiological evaluation of the novel coronavirus disease 2019 (COVID-19) on computed tomography (CT) images. The categorical CT assessment scheme (CO-RADS) categorizes lung parenchymal changes according to their likelihood of being caused by SARS-CoV-2 infection. This study investigates the diagnostic accuracy of diagnosing COVID-19 with CO-RADS compared to the Thoracic Imaging Section of the German Radiological Society (DRG) classification and Radiological Society of North America (RSNA) classification in an anonymized patient cohort. To mimic advanced disease stages, follow-up examinations were included as well.

METHOD: This study includes all patients undergoing chest CT in the case of a suspected SARS-CoV-2 infection or an already confirmed infection between March 13 and November 30, 2020. During the study period, two regional lockdowns occurred due to high incidence values, increasing the pre-test probability of COVID-19. Anonymized CT images were reviewed retrospectively and in consensus by two radiologists applying CO-RADS, DRG, and RSNA classification. Afterwards, CT findings were compared to results of sequential real-time reverse transcriptase polymerase chain reaction (qPCR) test performed during hospitalization to determine statistical analysis for diagnosing COVID-19.

RESULTS: 536 CT examinations were included. CO-RADS, DRG and RSNA achieved an NPV of 96 %/94 %/95 % (CO-RADS/DRG/RSNA), PPV of 83 %/80 %/88 %, sensitivity of 86 %/76 %/80 %, and specificity of 96 %/95 %/97 %. The disease prevalence was 20 %.

CONCLUSION: All applied classifications can reliably exclude a SARS-CoV-2 infection even in an anonymous setting. Nevertheless, pre-test probability was high in our study setting and has a great influence on the classifications. Therefore, the applicability of the individual classifications will become apparent in the future with lower prevalence and incidence of COVID-19.

KEY POINTS: · CO-RADS, DRG, and RSNA classifications help to reliably detect infected patients in an anonymized setting. · Pre-test probability has a great influence on the individual classifications. · Difficulties in an anonymized study setting are severe pulmonary changes and residuals..

CITATION FORMAT: · Valentin B, Steuwe A, Wienemann T et al. Applicability of CO-RADS in an Anonymized Cohort Including Early and Advanced Stages of COVID-19 in Comparison to the Recommendations of the German Radiological Society and Radiological Society of North America. Fortschr Röntgenstr 2022; DOI: 10.1055/a-1740-4310.

PMID:35211925 | DOI:10.1055/a-1740-4310

Mem Cognit. 2022 Feb 24. doi: 10.3758/s13421-021-01272-0. Online ahead of print.

ABSTRACT

The present study aimed to investigate the mechanism underlying the development of level 2 visual perspective taking (VPT2). Specifically, we examined the role of working memory capacity (WMC) and mental rotation (MR) in the developmental change of VPT2 among early school-aged children. Children aged between 6 and 8 years (N = 150) completed measures to assess WMC, MR, and VPT2. Results showed that WMC, the ability of MR, and VPT2 developed progressively from 6 to 8 years old. The ability of VPT2 was significantly correlated with WMC and MR, even when age was statistically controlled for. Mediation analyses further revealed that both age-related changes in WMC and MR partially mediated the development of VPT2. Furthermore, age-related development in MR mediated the relationship between changes of WMC and VPT2. Our findings suggest the importance of WMC and MR in the early development of VPT2 and provide preliminary support for the developmental cascade hypothesis. That is, as children grow up, their WMC increases, leading to better capability of MR, which in turn results in the improvement of VPT2.

PMID:35211866 | DOI:10.3758/s13421-021-01272-0

Langenbecks Arch Surg. 2022 Feb 25. doi: 10.1007/s00423-022-02434-7. Online ahead of print.

ABSTRACT

PURPOSE: To clarify the efficacy of perioperative chemotherapy for the patients with resectable colorectal liver metastases (CLM), we conducted a multicenter randomized phase III trial to compare surgery followed by postoperative FOLFOX regimen with perioperative FOLFOX regimen plus cetuximab in patients with KRAS wild-type resectable CLM.

METHODS: Patients who had KRAS wild-type resectable CLM having one to eight liver nodules without extrahepatic disease were randomly assigned to the postoperative chemotherapy group, wherein up-front hepatectomy was performed followed by 12 cycles of postoperative modified FOLFOX6, and the perioperative chemotherapy group (experimental), wherein six cycles of preoperative modified FOLFOX6 plus cetuximab were performed followed by hepatectomy and six cycles of postoperative modified FOLFOX6 plus cetuximab. The primary endpoint was progression-free survival (PFS).

RESULTS: There were 37 patients in postoperative chemotherapy group and 40 patients in the perioperative chemotherapy group who were analyzed. Baseline characteristics were well-balanced between groups. The PFS and overall survival (OS) showed no significant difference (PFS, hazard ratio 1.18 [95% confidence interval 0.69-2.01], P = 0.539: OS, 1.03 [0.46-2.29], P = 0.950). In the postoperative chemotherapy group, 35.1% had a 3-year PFS, and 86.5% had a 3-year OS. Meanwhile, in the perioperative chemotherapy group, 30.0% had a 3-year PFS, and 74.4% had a 3-year OS.

CONCLUSION: There was no difference in survival found between the group of the perioperative chemotherapy plus cetuximab and that of the postoperative chemotherapy in the cohort of our study. The study was registered in the University Hospital Medical Information Network (UMIN000007787).

PMID:35211831 | DOI:10.1007/s00423-022-02434-7

Ann Surg Oncol. 2022 Feb 24. doi: 10.1245/s10434-022-11444-0. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the prognostic value of the percentage of high-grade patterns (micropapillary, solid, and complex glands) in early-stage lung adenocarcinoma (LUAD).

METHODS: A total of 1049 patients undergoing radical surgery with pathological T1-2N0M0 LUAD were screened retrospectively, and 191 patients were involved in the final analysis. Disease-free survival (DFS) was evaluated using the Kaplan-Meier curve and Cox regression analysis. The optimal cut-off value was determined using maximally selected rank statistics.

RESULTS: The entire cohort was divided into quartile groups based on the percentage of high-grade patterns: Group 1 (≤ 30%), Group 2 (31-55%), Group 3 (56-85%), and Group 4 (≥ 86%). There were significant differences in smoking history (P = 0.041), EGFR mutations (P < 0.001), and ALK rearrangement (P = 0.010) between the four groups, but no significant differences in other clinicopathological features. Kaplan-Meier analysis showed that a higher percentage of high-grade patterns predicted worse DFS (P = 0.001), and multivariate analysis indicated that the percentage of high-grade patterns was an independent predictor (Group 2 vs. Group 1, HR = 2.136, P = 0.228; Group 3 vs. Group 1, HR = 3.355, P = 0.035; Group 4 vs. Group 1, HR = 5.147, P = 0.003, respectively). A cut-off value of 20% (P = 0.048) and 50% (P <0.001) for high-grade patterns were tested, and both revealed a significant difference in distinguishing DFS between subgroups.

CONCLUSIONS: The percentage of high-grade patterns is associated with the prognosis of early-stage invasive LUAD. A higher percentage indicates a worse prognosis.

PMID:35211858 | DOI:10.1245/s10434-022-11444-0

Eur J Pediatr. 2022 Feb 24. doi: 10.1007/s00431-022-04427-6. Online ahead of print.

ABSTRACT

Fresh frozen plasma (FFP) is largely misused in the neonatal setting. The aim of the study is to evaluate the impact of a Thromboelastography (TEG)-based Quality Improvement (QI) project on perioperative FFP use and neonatal outcomes. Retrospective pre-post implementation study in a level-III NICU including all neonates undergoing major non-cardiac surgery before (01-12/2017) and after (01-12/2019) the intervention. In 2018, the intervention included the following: (1) Training on TEG, (2) Implementation of TEG, and (3) Algorithm for TEG-directed FFP administration in surgical neonates. We compared pre- vs post-intervention patient characteristics, hemostasis, and clinical management. Linear and logistic regression models were used to evaluate the impact of the project on main outcomes. We analyzed 139 neonates (pre-intervention: 72/post-intervention: 67) with a mean (± SD) gestational age (GA) 34.9 (± 5) weeks and birthweight 2265 (± 980) grams which were exposed to 184 surgical procedures (pre-intervention: 91/post-intervention: 93). Baseline characteristics were similar between periods. In 2019, prothrombin time (PT) was longer (14.3 vs 13.2 s; p < 0.05) and fibrinogen was lower (229 vs 265 mg/dl; p < 0.05), if compared to 2017. In 2019, the intraoperative exposure to FFP decreased (31% vs 60%, p < 0.001), while the pre-operative FFP use did not change. The reduction of intraoperative FFP did not impact on mortality and morbidity. Intraoperative FFP use was lower in the post-intervention even after controlling for GA, American Society of Anesthesiologists score, PT, and fibrinogen (Odds ratio: 0.167; 95% CI: 0.070, 0.371). Conclusion: The TEG-based QI project for the management of FFP during neonatal surgery reduced intraoperative FFP exposure. What is Known: • PT and aPTT are poor predictors of bleeding risk in acquired neonatal coagulopathy, leading to likely unnecessary fresh frozen plasma (FFP) transfusion in the Neonatal Intensive Care Setting. • As neonatal hemostasis is a delicate balance between the concomitant reduction of pro- and anti-coagulants drivers, thromboelastography (TEG) is a promising alternative for coagulation monitoring. What is New: • The implementation of TEG, training, and shared protocols contributed to reduced intraoperative FFP use, which was not associated with increased mortality or bleeding events. • These findings inform future research showing that there is clinical equipoise to allow for larger studies to confirm the use of TEG in NICUs and to identify TEG cut-offs for transfusion practice.

PMID:35211816 | DOI:10.1007/s00431-022-04427-6

Anesth Analg. 2022 Feb 24. doi: 10.1213/ANE.0000000000005915. Online ahead of print.

ABSTRACT

BACKGROUND: Postoperative negative behavioral changes (NBCs) are common among children, but risk for this is thought to be reduced with premedication. Midazolam has for many years been a standard premedication for children. More recently, the alpha-2 adrenergic agonist clonidine has also become popular as a preanesthetic sedative. We hypothesized that clonidine was superior to midazolam for limiting new NBCs in children as assessed using the Post Hospital Behavior Questionnaire (PHBQ).

METHODS: This was a prospective, randomized, controlled, blinded study, including 115 participants aged 24 to 95 months and their parents. The participants underwent ear, nose, or throat outpatient surgery and were randomly allocated to premedication with oral midazolam 0.5 mg/kg or oral clonidine 4 µg/kg. Participants were anesthetized by protocol. At home, later, parents were asked to complete the PHBQ assessment instrument for postoperative NBCs for the participants 1 week, 1 month, and 6 months after the surgery. A secondary outcome, preinduction anxiety, was assessed using modified Yale Preoperative Anxiety Scale (mYPAS).

RESULTS: The primary outcome, more than 3 NBCs in an individual case at 1 week, showed no difference in proportions between treatment in the clonidine group compared to the midazolam group, (12/59 or 20% vs 7/56 or 13%, respectively, odds ratio 1.39, 95% confidence interval [CI], 0.75-2.58; P = .32). A secondary result showed a higher preinduction anxiety level in the clonidine compared to the midazolam group (mYPAS >30, 43/59 or 71% vs 12/56 or 21%, respectively; P < .001).

CONCLUSIONS: These results did not show a clinical or statistically significant difference, with respect to the primary outcome of behavior changes at 1 week, between the cohorts that received midazolam versus clonidine as a premedication.

PMID:35203087 | DOI:10.1213/ANE.0000000000005915

Obes Facts. 2022 Feb 24. doi: 10.1159/000522651. Online ahead of print.

ABSTRACT

INTRODUCTION: Obesity is a global problem incurring substantial health and economic implications. This has been highlighted by the ongoing COVID-19 pandemic which disproportionately affected obese individuals. Most interventions have concentrated on promotion of physical activities and healthy eating which may involve current sacrifices for future health gains. This study explored the relationship between bodyweight and how individuals state they would trade off immediate income for higher amounts in the future (time-preference) Methods: An online survey was conducted targeting adults aged > 16 years in UK from 1/01/2016 to 31/07/2016. Using paid online adverts, as well as personal and professional networks for distribution of links to the online survey, the questionnaire asked respondents to report socio-economic and demographic information, height and weight and to complete a time-preference exercise. Data were analysed using descriptive statistics; associations were explored between BMI and respondents’ characteristics and time preference using Spearman rank-order correlation and Chi-square tests as appropriate. We adopted STROBE guidelines for the reporting of the study.

RESULTS: A total of 561 responses were analysed (female = 293, males = 268). The relationship between time-preference and overweight/obese, using BMI as the measure, is highly significant (Chi-Square = 95.92: P < 0001). Individuals of normal weight have low time preference and more likely to invest in activities in a bid to reap future health benefits. There are also significant relationships between BMI and employment status (Chi-Square = 37.03; P < 0.001), physical activities (P < 0.0001), income levels (Chi-Square = 6.68; P < 0.035), family orientation i.e. with or without children (Chi-Square = 12.88; P < 0.012) and ethnicity (Chi-Square = 18.31; P < 0.001). These imply that individuals in employment and with children in their families are less likely to be overweight or obese compared to those who do not. People from black backgrounds are also more likely to be overweight or obese and have higher time-preference compared to people from white backgrounds.

DISCUSSIONS/CONCLUSIONS: People’s preventive behaviours today can be predicted by their time preference and this understanding could be vital in improving population’s uptake and maintenance of overweight and obesity prevention actions. People who have low time-preference are more likely to invest time and resources in physical activities and healthy lifestyles to reap future health benefits hence value utilities-in-anticipation.

PMID:35203081 | DOI:10.1159/000522651

Folia Phoniatr Logop. 2022 Feb 24. doi: 10.1159/000523686. Online ahead of print.

ABSTRACT

OBJECTIVE: The purpose of this investigation was to assess clinician and patient feedback about voice therapy using a variably occluded face mask (VOFM), and to determine if voice therapy augmented via a VOFM would result in favorable changes in patient self-perceived handicap, as well as acoustic and aerodynamic measures.

METHODS/DESIGN: Pilot, prospective, pre-post single group design. Eleven patients with dysphonia due to primary muscle tension dysphonia (8) or benign vocal fold lesions (3) were recruited. Data collected included patient and clinician feedback of voice therapy using a VOFM, voice handicap index (VHI)-10, acoustic and aerodynamic measures. Data were collected before treatment (baseline) and one-week post therapy. Wilcoxon signed-rank tests were used to compare data pre and post therapy.

RESULTS: Statistically significant improvement was observed for the VHI-10 with a median delta of -7. Clinician feedback generally reported that patients like the VOFM, using the VOFM within the first two sessions of therapy, and within less than 10 minutes of use. All clinicians ranked the conversation level of the hierarchy as the most effective level. Three themes emerged from the Therapy Feedback Form: the SOFM was a 1) “Facilitator for Sensation,” 2) a “Physical Tool”; and that there was 3) “No Program Needed” to use the VOFM in voice therapy. There was a statistically significant improvement in CPP (p=0.0329) and CSID (p=0.0164) in sustained vowels.

DISCUSSION: This pilot study represents the first investigation into clinician and patient perceptions of using a variably occluded face mask (VOFM). Reported measures via patient perception, as well as clinician perceptions, and some acoustic and aerodynamic measures showed that participants got better with VOFM voice therapy. Last, in general, both clinicians and patients liked utilizing a VOFM in voice therapy.

PMID:35203078 | DOI:10.1159/000523686

Epilepsy Behav. 2022 Jan 24;129:108581. doi: 10.1016/j.yebeh.2022.108581. Online ahead of print.

ABSTRACT

INTRODUCTION: In 2020, Coronavirus Disease 2019 (COVID-19) was declared as a global pandemic. Self-reported stress, anxiety, and insomnia, which are believed to be common triggers for epilepsy, are more likely to occur. We aimed to establish the influence of COVID-19 pandemic itself on changes in the daily life routine related to pandemic on epilepsy course in pediatric patients. The unique form of clinical care which is telemedicine was also taken into consideration. We wanted to evaluate patients’ satisfaction with telemedicine and if changing stationary visits into telemedicine influenced epilepsy course in our patients.

METHODS: Patients, who attended developmental neurology outpatient clinic in the period March-December 2020 were collected. As patients were minors, legal guardians were asked to fill out the questionnaire. Patients were divided according to the outcome into three groups: those with a worsened, stable, or improved course of epilepsy during the pandemic. Appropriate statistical tests for two-group and multi-group comparisons have been implemented. Post hoc p values were also calculated.

RESULTS: Four hundred and two questionnaires were collected. Most of the patients had a stable course of epilepsy during the pandemic; in 13% of participants an improvement has been observed, worsening of the disease was seen in 16% of patients. Age, sex, type of epilepsy, number of seizure incidents before pandemic, and duration of the disease had no statistically significant connection with changes in the course of the disease. Behavioral changes and altered sleep patterns were found to be more common in the worsened group. Fifty-eight percent of patients were satisfied with telemedicine. Poorer satisfaction was connected with less frequent visits, cancellation of scheduled appointments, and lack of help in case of need in an emergency situation.

CONCLUSION: Epilepsy course in pediatric patients seems to be stable during COVID-19 pandemic. Sleep disturbances and changes in a child’s behavior may be related to increase in seizure frequency. Telemedicine is an effective tool for supervising children with epilepsy. Patients should be informed about possible ways of getting help in urgent cases.

PMID:35203013 | DOI:10.1016/j.yebeh.2022.108581