Category: Nevin Manimala

Neurospine. 2021 Dec;18(4):839-844. doi: 10.14245/ns.2142560.180. Epub 2021 Dec 31.

ABSTRACT

OBJECTIVE: To identify potential risk factors of unsatisfactory screw position during robot-assisted pedicle screw fixation.

METHODS: A retrospective analysis of robot-assisted pedicle screw fixation performed in Beijing Jishuitan Hospital from March 2018 to March 2019 was conducted. Research data was collected from the medical record and imaging systems. Univariate tests were performed on the potential risk factors (patient’s characteristics and surgical factors) of unsatisfactory screw position during robot-assisted pedicle screw fixation. For statistically significant variables in univariate tests, a logistic regression test was used to identify independent risk factors for unsatisfactory screw position.

RESULTS: A total of 780 pedicle screws placed in 163 robot-assisted surgeries were analyzed. The rate of perfect screw positions was 93.08%, and the unsatisfactory rate was 6.92%. In patients with severe obesity (body mass index ≥ 30 kg/m2) (odds ratio [OR], 2.459; 95% confidence interval [CI], 1.199-5.044; p = 0.014), osteoporosis (T ≤ -2.5) (OR, 1.857; 95% CI, 1.046-3.295; p = 0.034), and the segments 3 levels away from the tracker (OR, 2.216; 95% CI, 1.119-4.387; p = 0.022), robot-assisted pedicle screw placement has a higher risk of screw malposition.

CONCLUSION: During robot-assisted pedicle screw placement for patients with severe obesity, osteoporosis, and segments 3 levels away from the tracker, vigilance should be maintained during surgery to avoid postoperative complications due to unsatisfactory screw position.

PMID:35000338 | DOI:10.14245/ns.2142560.180

Neurospine. 2021 Dec;18(4):786-797. doi: 10.14245/ns.2142712.356. Epub 2021 Dec 31.

ABSTRACT

OBJECTIVE: Ankylosing spondylitis (AS) is a rheumatic inflammatory disease marked by chronic inflammation of the axial skeleton. This condition, particularly when severe, can lead to increased risk of vertebral fractures attributed to decreased ability of the stiffened spinal column to sustain normal loads. However, little focus has been placed on understanding the locations of spinal fractures and associated complications and assessing the correlation between these. In this review, we aim to summarize the complications and treatment patterns in the United States in AS patients with spinal fractures, using the latest Nationwide Inpatient Sample (NIS) database (2016-2018).

METHODS: We analyzed the NIS data of years 2016-2018 to compare the fracture patterns and complications.

RESULTS: A total of 5,385 patients were included. The mean age was 71.63 years (standard deviation [SD], 13.21), with male predominance (83.8%). The most common population is Whites (77.4%), followed by Hispanics (7.9%). The most common fracture level was thoracic level (58.3%), followed by cervical level (38%). Multiple fracture levels were found in 13.3% of the patients. Spinal cord injury (SCI) was associated with 15.8% of the patients. The cervical level had a higher proportion of SCI (26.5%), followed by thoracic level (9.2%). The mean Elixhauser comorbidity score was 4.82 (SD, 2.17). A total of 2,365 patients (43.9%) underwent surgical treatment for the fractures. The overall complication rate was 40.8%. Respiratory complications, including pneumonia and respiratory insufficiency, were the predominant complications in the overall cohort. Based on the regression analysis, there was no significant difference (p = 0.45) in the complication rates based on the levels. The presence of SCI increased the odds of having a complication by 2.164 times (95% confidence interval, 1.722-2.72; p ≤ 0.001), and an increase in Elixhauser comorbidity score predicted the complication and in-hospital mortality rate (p ≤ 0.001).

CONCLUSION: AS patients with spinal fractures have higher postoperative complications than the general population. The most common fracture location was thoracic in our study, although it differs with few studies, with SCI occurring in 1/6th of the patients.

PMID:35000333 | DOI:10.14245/ns.2142712.356

Dermatol Ther. 2022 Jan 9:e15311. doi: 10.1111/dth.15311. Online ahead of print.

ABSTRACT

Acne vulgaris is one of the most common dermatologic complaints. Recently, isotretinoin has been used as an off-label indication for the treatment of mild-to-moderate grades of acne not responding to conventional treatment. Its conventional recommended dose is 0.5-1.0 mg/kg per day to the cumulative dose of 120-150 mg/kg.

OBJECTIVES: To qualify the state of evidence and analyze the efficacy of the low daily dose and the pulsed doses of isotretinoin in treating mild-to-moderate acne patients with regards to response and relapse rates.

METHOD: Systematic review and meta-analysis using an electronic literature search were performed. 320 potentially relevant articles were included and reviewed.

RESULTS: The level of evidence is moderate to low as conducted by the GRADE quality of evidence assessment. The pooled statistical estimate for response to treatment in the group comparing low daily doses with conventional dose showed an overall benefit for conventional dose. On the other hand, pooled data from the group comparing the low daily dose with the pulsed doses yielded an overall beneficial effect from using the low daily dose compared with the pulsed doses on achieving the response.

CONCLUSIONS: Given all of the available studies, the quality of evidence is low. It appears that conventional dose isotretinoin improves the odds of prolonged remission in adults with mild-to-moderate acne vulgaris compared to the low doses.

PMID:35000295 | DOI:10.1111/dth.15311

Neurospine. 2021 Dec;18(4):667-680. doi: 10.14245/ns.2142206.253. Epub 2021 Dec 31.

ABSTRACT

To formulate the specific guidelines for the recommendation of thoracolumbar fracture regarding surgical techniques and nonfusion surgery. WFNS (World Federation of Neurosurgical Societies) Spine Committee organized 2 consensus meeting. For nonfusion surgery and thoracolumbar fracture, a systematic literature search in PubMed and Google Scholar database was done from 2010 to 2020. The search was further refined by excluding the articles which were duplicate, not in English or were based on animal or cadaveric subjects. After thorough shortlisting, only 50 articles were selected for full review in this consensus meeting. To generate a consensus, the levels of agreement or disagreement on each item were voted independently in a blind fashion through a Likert-type scale from 1 to 5. The consensus was achieved when the sum for disagreement or agreement was ≥ 66%. Each consensus point was clearly defined with evidence strength, recommendation grade, and consensus level provided. A magnitude of prospective papers were analyzed to formulate consensus on various surgical techniques that can be employed to address different types of thoracolumbar fractures. Surgical treatment of thoracolumbar fractures can be a better option over the nonoperative approach, especially for those who cannot tolerate months in an orthosis or cast, such as those with multiple extremity injuries, skin lesions, obesity, and so forth. It generally allows early mobilization, less hospital stay, reduced pulmonary complications, and better correction of sagittal balance. Current available literature fails to demonstrate any statistically significant benefit of fusion surgery over nonfusion in thoracolumbar fractures.

PMID:35000320 | DOI:10.14245/ns.2142206.253

J Sep Sci. 2022 Jan 9. doi: 10.1002/jssc.202100732. Online ahead of print.

ABSTRACT

Pulsatillae Radix, the root of Pulsatilla chinensis (Bge.) Regel, is recorded in the Pharmacopoeia of the People’s Republic of China and has been widely used for its pharmacological activities, such as anti-inflammatory, antioxidant, antibacterial, antitumor, and cardiovascular benefits. However, there are several look-alike species that can be marketed as Pulsatillae Radix. To distinguish Pulsatilla chinensis (Bge.) Regel from its look-alikes, viz. Pulsatilla cernua (Thunb.) Bercht et Opiz., Pulsatilla dahurica (Fisch.) Spreng., Anemone tomeutosa (Maxim.) Pei., and Rhaponticum uniflorum (L.) DC, we used ultra-performance liquid chromatography/time-of-flight mass spectrometry combined with principal component analysis to compare their chemical compositions. Four ions, a (RT 8.98 min, m/z 1381.6671), b (RT 10.64 min, m/z 1219.6143), c (RT 11.52 min, m/z 1217.5978), and d (RT 13.6 min, m/z 749.4463) from Pulsatillae chinensis (Bge.) Regel were identified as potential chemical markers to distinguish it from look-alike species using an unsupervised statistical model combined with orthogonal partial least-squares discriminant analysis. The results of this study provide an effective method for identifying and distinguishing Pulsatilla chinensis (Bge.) Regel from similar plants. This article is protected by copyright. All rights reserved.

PMID:35000282 | DOI:10.1002/jssc.202100732

Mol Oncol. 2022 Jan 9. doi: 10.1002/1878-0261.13179. Online ahead of print.

ABSTRACT

Breast cancer is a heterogeneous disease that comprises multiple histological and molecular subtypes. To gain insight into mutations that drive breast tumorigenesis, we describe a pipeline for the identification and validation of tumor suppressor genes. Based on an in vivo genome-wide CRISPR/Cas9-screen in Trp53^+/- heterozygous mice, we identified tumor suppressor genes that include the scaffold protein Axin1, the protein kinase A regulatory subunit gene Prkar1a, as well as the proof-of-concept genes Pten, Nf1 and Trp53 itself. Ex vivo editing of primary mammary epithelial organoids was performed to further interrogate the roles of Axin1 and Prkar1a. Increased proliferation and profound changes in mammary organoid morphology were observed for Axin1/Trp53 and Prkar1a/Trp53 double mutants compared to Pten/Trp53 double mutants. Furthermore, direct in vivo genome editing via intraductal injection of lentiviruses engineered to express dual short-guide RNAs revealed that mutagenesis of Trp53 and either Prkar1a, Axin1 or Pten markedly accelerated tumor development compared to Trp53-only mutants. This proof-of-principle study highlights the application of in vivo CRISPR/Cas9-editing for uncovering cooperativity between defects in tumor suppressor genes that elicit mammary tumorigenesis.

PMID:35000262 | DOI:10.1002/1878-0261.13179

Cytometry A. 2022 Jan 9. doi: 10.1002/cyto.a.24533. Online ahead of print.

ABSTRACT

Automated cell segmentation is key for rapid and accurate investigation of cell responses. As instrumentation resolving power increases, clear delineation of newly revealed cellular features at the sub-micron through nanoscale becomes important. Reliance on manual investigation of myriad small features retards investigation; however, use of deep learning methods has great potential to reveal cell features both at high accuracy and high speed, which may lead to new discoveries in the near term. In this study, semantic cell segmentation systems were investigated by implementing fully convolutional neural networks called U-nets for segmentation of astrocytes cultured on Poly-L-lysine-functionalized planar glass. The network hyperparameters were determined by changing the number of network layers, loss functions, and input image modalities. Atomic force microscopy (AFM) images were selected for investigation as these are inherently nanoscale and are also dimensional. AFM height, deflection, and friction images were used as inputs separately and together, and the segmentation performances were investigated on five-fold cross-validation data. Transfer learning methods, including VGG16, VGG19, and Xception, were used to improve cell segmentation performance. We find that AFM height images inherit more discriminative features than AFM deflection and AFM friction images for cell segmentation. When transfer learning methods are applied, statistically significant segmentation performance improvements are observed. Segmentation performance was compared to classical image processing algorithms and other algorithms in use by considering both AFM and electron microscopy segmentation. An accuracy of 0.9849, Matthews correlation coefficient of 0.9218, and Dice’s similarity coefficient of 0.9306 were obtained on the AFM test images. Performance evaluations show that the proposed system can be successfully used for AFM cell segmentation with high precision. This article is protected by copyright. All rights reserved.

PMID:35000269 | DOI:10.1002/cyto.a.24533

J Psychiatr Ment Health Nurs. 2022 Jan 9. doi: 10.1111/jpm.12818. Online ahead of print.

ABSTRACT

INTRODUCTION: HT has been widely used to promote mental health. However, heterogeneity and sample size issues of randomised-controlled trials made it challenging to illustrate effect sizes across the evidence.

AIM: The purpose of this meta-analysis was to explore the effect of HT on mental health.

METHODS: We used the PRISMA framework. A keyword search of Web of Science, PubMed, ProQuest, and Cochrane was performed. The inclusion criteria were HT with RCTs and mental health assessments. A random-effects model was used to perform the meta-analysis.

RESULTS: A total of 1,056 records were searched, and 18 eligible studies extracted. The included RCTs had no statistical heterogeneity and publication bias. The meta-analysis showed that the HT experimental groups had a significant and positive impact on mental health compared to the control groups (effect size = 0.55).

DISCUSSION: HT should be considered for enhancing mental health. The included studies had no negative outcomes and the most common HT intervention was at least eight sessions. Therefore, HT should be considered to enhance mental health. However, the concealed allocation and blinding processes should be improved in future studies.

IMPLICATIONS FOR PRACTICE: This study recommends that HT should be integrated into healthcare settings to improve mental health.

PMID:35000249 | DOI:10.1111/jpm.12818

Mol Ecol. 2022 Jan 9. doi: 10.1111/mec.16343. Online ahead of print.

ABSTRACT

The shifts in adaptive strategies revealed by ecological succession and the mechanisms that facilitate these shifts are fundamental to ecology. These adaptive strategies could be particularly important in communities of arbuscular mycorrhizal fungi (AMF) mutualistic with sorghum where strong AMF succession replaces initially ruderal species with competitive ones and where the strongest plant response to drought is to manage these AMF. Although most studies of agriculturally important fungi focus on parasites, the mutualistic symbionts, AMF, constitute a research system of human-associated fungi whose relative simplicity and synchrony are conducive to experimental ecology. First, we hypothesize that, when irrigation is stopped to mimic drought, competitive AMF species should be replaced by AMF species tolerant to drought stress. We then, for the first time, correlate AMF abundance and host plant transcription to test two novel hypotheses about the mechanisms behind the shift from ruderal to competitive AMF. Surprisingly, despite imposing drought stress, we found no stress tolerant AMF, likely due to our agricultural system having been irrigated for nearly six decades. Remarkably, we found strong and differential correlation between the successional shift from ruderal to competitive AMF and sorghum genes whose products (i) produce and release strigolactone signals, (ii) perceive mycorrhizal-lipochitinoligosaccharide (Myc-LCO) signals, (iii) provide plant lipid and sugar to AMF and, (iv) import minerals and water provided by AMF. These novel insights frame new hypotheses about AMF adaptive evolution and suggest a rationale for selecting AMF to reduce inputs and maximize yields in commercial agriculture.

PMID:35000239 | DOI:10.1111/mec.16343

J Oral Rehabil. 2022 Jan 9. doi: 10.1111/joor.13304. Online ahead of print.

ABSTRACT

BACKGROUND: Parkinson’s disease (PD) is a neurodegenerative condition affecting quality of life. Due to a worsening of oral health in PD patients with the progression of the disease, oral health-related quality of life (OHRQoL) could be impaired as well.

OBJECTIVES: To assess whether PD patients in The Netherlands experience worse OHRQoL than historical controls, and to investigate which factors are associated with OHRQoL in PD patients.

MATERIAL & METHODS: In total, 341 PD patients (65.5 ± 8.4 years) and 411 historical controls (62.6 ± 5.3 years) participated. Both groups completed a questionnaire. The PD patients were asked questions regarding demographics, PD, oral health, and OHRQoL. The historical controls filled in demographic information and questions regarding OHRQoL. The latter construct was assessed using the Dutch 14-item version of the Oral Health Impact Profile (OHIP-14). Data were analysed using independent samples t-tests and univariate and multivariate linear regression analysis.

RESULTS: The mean OHIP-14 score was higher in PD patients (19.1 ± 6.7) than in historical controls (16.5 ± 4.4) (t(239)=6.5; p<0.001). OHRQoL in PD patients was statistically significant associated with motor aspects of experiences of daily living (B=0.31; t(315)=7.03p<0.001), worsening of the oral environment during disease course (B=3.39; t(315)=4.21p<0.001), being dentate (B= -5.60; t(315)=-4.5; p<0.001), tooth wear (B=2.25; t(315)=3.29; p=0.001), and possible burning mouth syndrome (B=5.87; t(315)=2.87; p=0.004).

CONCLUSION: PD patients had a lower OHRQoL than historical controls. Besides, PD-related variables and oral health-related variables were associated with OHRQoL.

PMID:35000220 | DOI:10.1111/joor.13304