Category: Nevin Manimala

JMIR Public Health Surveill. 2022 Jan 6. doi: 10.2196/32426. Online ahead of print.

ABSTRACT

BACKGROUND: Early estimates of excess mortality are crucial for understanding the impact of COVID-19. However, there is a lag of several months in the reporting of vital statistics mortality data for many jurisdictions, including across Canada. In Ontario, a Canadian province, certification by a coroner is required before cremation can occur, creating real-time mortality data that encompasses the majority of deaths within the province.

OBJECTIVE: This study aimed to validate the use of cremation data as a more timely surveillance tool for all-cause mortality during a public health emergency in a jurisdiction with delays in vital statistics data. Specifically, this study aimed to validate this surveillance tool by determining the stability, timeliness, and robustness of its real-time estimation of all-cause mortality.

METHODS: Cremation records from January 2020 until April 2021 were compared to the historical records from 2017-2019, grouped according to week, age, sex, and COVID-19 status. Cremation data were compared to Ontario’s provisional vital statistics mortality data released by Statistics Canada. The 2020 and 2021 records were then compared to previous years (2017-2019) to determine whether there was excess mortality within various age groups and whether deaths attributed to COVID-19 account for the entirety of the excess mortality.

RESULTS: Between 2017-2019, cremations were performed for 67.4% (95% CI: 67.3-67.5%) of deaths; the proportion of cremated deaths remained stable throughout 2020, even within age and sex categories. Cremation records are 99% complete within three weeks of the data of death, which precedes the compilation of vital statistics data by several months. Consequently, during the first wave (from April to June 2020), cremation records detected a 16.9% increase (95% CI: 14.6-19.3%) in all-cause mortality, a finding which was confirmed several months later with cremation data.

CONCLUSIONS: The percent of Ontarians cremated and the completion of cremation data several months before vital statistics did not change meaningfully during the COVID-19 pandemic period, establishing that the pandemic did not significantly alter cremation practices. Cremation data can be used to accurately estimate all-cause mortality in near real-time, particularly when real-time mortality estimates are needed to inform policy decisions for public health measures. The accuracy of this excess mortality estimation was confirmed by comparing it with official vital statistics data. These findings demonstrate the utility of cremation data as a complementary data source for timely mortality information during public health emergencies.

PMID:35038302 | DOI:10.2196/32426

Clin Child Psychol Psychiatry. 2022 Jan 17:13591045211067556. doi: 10.1177/13591045211067556. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effect of anxiety of parent accompanying child on child’s anxiety during treatment.

METHODS: The study included two groups: one group with 80 children whose parents were anxious, and the other group with 80 children with non-anxious parents, totaling 160 children. Each group was further randomized into subgroups, with and without parents accompanying their children. The children’s heart rates were measured using a portable pulse oximeter during the treatment. The child’s perception was measured using the Wong-Baker Faces Rating Scale, and another pediatric dentist rated child’s behavior using the Frankl scale based on the treatment video that was limited to the child’s appearance.

RESULTS: The highest pulse rates were observed in children accompanied by an anxious parent (p < .001). Values on the Wong-Baker scale did not differ according to parental anxiety and parental presence (p > .05). According to the dentist, the presence of parents negatively affected the anxiety of the child (p = .025), while the effect of parents’ anxiety was not statistically significant (p = .514).

CONCLUSIONS: The anxiety of parent accompanying the child affects child’s anxiety. Parents with high anxiety appeared to negatively affect their children’s behavior.

PMID:35038278 | DOI:10.1177/13591045211067556

Clin Child Psychol Psychiatry. 2022 Jan 17:13591045211061800. doi: 10.1177/13591045211061800. Online ahead of print.

ABSTRACT

The Diagnostic Interview Schedule for Children Adolescents and Parents (DISCAP) is a semi-structured diagnostic interview for assessing psychiatric disorders in children and adolescents. Changes to diagnostic criteria introduced in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) required the DISCAP to be revised accordingly. The aim of this study was to evaluate the reliability and validity of the updated DISCAP-5 in clinic-referred children. The DISCAP-5 was administered to parents of n=60 clinic-referred children aged 2-9 years with externalizing problems and a range of comorbid disorders. Inter-rater reliability data were collected using independent ratings of video-recorded DISCAP-5 interviews, and concurrent and discriminant validity were indexed against mother and father reports on the Strengths and Difficulties Questionnaire. Inter-rater reliability agreement was high for the presence and absence of any diagnosis, common externalizing (e.g., oppositional defiant disorder, conduct disorder) and internalizing disorders (separation anxiety disorder, generalized anxiety disorder), and severity of primary and secondary diagnoses. Rating scale data supported the concurrent and discriminant validity of diagnoses based on the DISCAP-5. The DISCAP-5 appears to provide valid and reliable data in the diagnostic assessment of clinic-referred children with behavioral and emotional difficulties across broad ranges of severity and complexity.

PMID:35038264 | DOI:10.1177/13591045211061800

Appl Neuropsychol Adult. 2022 Jan 17:1-6. doi: 10.1080/23279095.2021.2023155. Online ahead of print.

ABSTRACT

The General Ability Measure for Adults (GAMA) is a brief nonverbal assessment of general intellectual ability. Presently, there is a lack of research involving the use of the GAMA in a high-functioning population. Aviation pilots (n = 59) were referred for a neuropsychological evaluation and were concluded to be cognitively intact. They were administered a battery that included the GAMA and Wechsler Adult Intelligence Scale – 4th edition (WAIS-IV). A paired samples t-test revealed that IQ scores on the GAMA were significantly lower than IQ scores on the WAIS-IV, with WAIS-IV IQ being 7.54 points higher on average. Fisher’s exact test determined there was significant disagreement in score classification between the tests, with individuals classified as Above Average on the WAIS-IV often being classified as Average on the GAMA. The GAMA appears to significantly underrepresent true IQ in both score and classification when compared to a more robust measure of intellectual assessment. Clinically, this suggests that IQ screeners, such as the GAMA, may not be appropriate for assessing patients who are suspected to be of higher premorbid functioning. Future research should expand on these results to assess the validity of verbal-based IQ screening measures in high-functioning populations.

PMID:35038276 | DOI:10.1080/23279095.2021.2023155

J Magn Reson Imaging. 2022 Jan 17. doi: 10.1002/jmri.28065. Online ahead of print.

ABSTRACT

BACKGROUND: Readout-segmented echo-planar diffusion-weighted imaging (RS-EPI) can improve image quality and signal-to-noise ratio, the resulting apparent diffusion coefficient (ADC) value acts as a more sensitive biomarker to characterize tumors. However, data regarding the differentiation of breast cancer (BC) receptor statuses using RS-EPI are limited.

PURPOSE: To determine whether RS-EPI improves the differentiation of receptor statuses compared with conventional single-shot (SS) EPI in breast MRI.

STUDY TYPE: Retrospective.

POPULATION: A total of 151 BC women with the mean age of 50.6 years.

FIELD STRENGTH/SEQUENCE: A 3 T/ RS-EPI and SS-EPI.

ASSESSMENT: The ADCs of the lesion and normal background tissue from the two sequences were collected by two radiologists with 15 years of experience working of breast MRI (M.H.Z. and X.F.C.), and a normalized ADC was calculated by dividing the mean ADC value of the lesion by the mean ADC value of the normal background tissue.

STATISTICAL TESTS: Agreement between the ADC measurements from the two sequences was assessed using the Pearson correlation coefficient and Bland-Altman plots. One-way analysis of variance, Kruskal-Wallis test, and median difference were used to compare the ADC measurements for all lesions and different receptor statuses. A P value less than 0.05 indicated a significant result.

RESULTS: The ADC measurements of all lesions and normal background tissues were significantly higher on RS-EPI than on SS-EPI (1.82 ± 0.33 vs. 1.55 ± 0.30 and 0.83 ± 0.11 vs. 0.79 ± 0.10). The normalized ADC was lower on RS-EPI than on SS-EPI (0.47 ± 0.11 vs. 0.53 ± 0.12, a median difference of -0.04 [95% CI: -0.256 to 0.111]). For both diffusion methods, only the ADC measurement of RS-EPI was higher for human epidermal growth factor receptor-2 (HER-2)-positive tumors than for HER-2-negative tumors (0.87 ± 0.10 vs. 0.81 ± 0.11), and this measurement was associated with HER-2 positive status (adjusted odds ratio [OR] = 654.4); however, similar results were not observed for the ADC measurement of SS-EPI (0.80 ± 0.10 vs. 0.78 ± 0.11 with P = 0.199 and adjusted OR = 0.21 with P = 0.464, respectively).

DATA CONCLUSION: RS-EPI can improve the distinction between HER-2-positive and HER-2-negative breast cancer, complementing the clinical application of diffusion imaging.

EVIDENCE LEVEL: 3 TECHNICAL EFFICACY: Stage 1.

PMID:35038210 | DOI:10.1002/jmri.28065

PM R. 2022 Jan 17. doi: 10.1002/pmrj.12761. Online ahead of print.

NO ABSTRACT

PMID:35038235 | DOI:10.1002/pmrj.12761

Laryngoscope. 2022 Jan 17. doi: 10.1002/lary.30028. Online ahead of print.

ABSTRACT

OBJECTIVE: To quantify the effect of the COVID-19 pandemic upon the 2020-21 residency match for Otolaryngology-Head & Neck Surgery (OHNS).

METHODS: Residency match outcomes for all applicants to our institution during 2020-2021 were collected from the National Residency Matching Program (NRMP) including medical school of origin and matched program. Matches were categorized as to home-program, within-region, or out-of-region, and sorted by US geographic region. Matches from the 2020-2021 cycle were compared to those from 2019-2020, as well as averages and trends from match cycles 2016-2020. Statistical analysis included descriptive statistics and chi-square testing.

RESULTS: During 2020-2021, there were 436 applicants to our single OHNS program. From 2019-20 to 2020-21, the match rate decreased significantly for groups studied, including: All applicants (72.0% (268/372) to 64.7% (282/436); p = 0.025); All US MD Senior applicants (76.5% (254/332) to 68.9% 262/380); p = 0.024); and US MD Seniors specifically without a home program (77.5% (31/40) to 56.4% (22/39); p = 0.046). The match rate for US MD Seniors with a home program did not change significantly (76.4% (223/292) to 70.4% (240/341); p = 0.09). From 2019-20 to 2020-21, the proportion of US MD Seniors who matched to home-program increased significantly (22.0% (49/223) to 30.0% (72/240); p = 0.05).

CONCLUSION: The COVID-19 pandemic saw high volumes of OHNS applicants with an overall decreased rate of matching compared to previous years. These changes particularly affected applicants without home programs. Home-program matching increased significantly, likely as a consequence of the limitations placed on in-person away experiences including interviews.

PMID:35038190 | DOI:10.1002/lary.30028

J Magn Reson Imaging. 2022 Jan 17. doi: 10.1002/jmri.28061. Online ahead of print.

ABSTRACT

BACKGROUND: Currently, multi-parametric prostate MRI (mpMRI) consists of a qualitative T₂ , diffusion weighted, and dynamic contrast enhanced imaging. Quantification of T₂ imaging might further standardize PCa detection and support artificial intelligence solutions.

PURPOSE: To evaluate the value of T₂ mapping to detect prostate cancer (PCa) and to differentiate PCa aggressiveness.

STUDY TYPE: Retrospective single center cohort study.

POPULATION: Forty-four consecutive patients (mean age 67 years; median PSA 7.9 ng/mL) with mpMRI and verified PCa by subsequent targeted plus systematic MR/ultrasound (US)-fusion biopsy from February 2019 to December 2019.

FIELD STRENGTH/SEQUENCE: Standardized mpMRI at 3 T with an additionally acquired T₂ mapping sequence.

ASSESSMENT: Primary endpoint was the analysis of quantitative T₂ values and contrast differences/ratios (CD/CR) between PCa and benign tissue. Secondary objectives were the correlation between T₂ values, ISUP grade, apparent diffusion coefficient (ADC) value, and PI-RADS, and the evaluation of thresholds for differentiating PCa and clinically significant PCa (csPCa).

STATISTICAL TESTS: Mann-Whitney test, Spearman’s rank (r_s ) correlation, receiver operating curves, Youden’s index (J), and AUC were performed. Statistical significance was defined as P < 0.05.

RESULTS: Median quantitative T₂ values were significantly lower for PCa in PZ (85 msec) and PCa in TZ (75 msec) compared to benign PZ (141 msec) or TZ (97 msec) (P < 0.001). CD/CR between PCa and benign PZ (51.2/1.77), respectively TZ (19.8/1.29), differed significantly (P < 0.001). The best T₂ -mapping threshold for PCa/csPCa detection was for TZ 81/86 msec (J = 0.929/1.0), and for PZ 110 msec (J = 0.834/0.905). Quantitative T₂ values of PCa did not correlate significantly with the ISUP grade (r_s = 0.186; P = 0.226), ADC value (r_s = 0.138; P = 0.372), or PI-RADS (r_s = 0.132; P = 0.392).

DATA CONCLUSION: Quantitative T₂ values could differentiate PCa in TZ and PZ and might support standardization of mpMRI of the prostate. Different thresholds seem to apply for PZ and TZ lesions. However, in the present study quantitative T₂ values were not able to indicate PCa aggressiveness.

LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY: Stage 2.

PMID:35038203 | DOI:10.1002/jmri.28061

J Clin Ultrasound. 2022 Jan 17. doi: 10.1002/jcu.23143. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate if an automatic classification of rheumatoid arthritis (RA) metacarpophalangeal joint conditions in ultrasound images is feasible by deep learning (DL) method, to provide a more objective, automated, and fast way of RA diagnosis in clinical setting.

MATERIALS AND METHODS: DenseNet-based DL model was used and both training and testing are implemented in TensorFlow 1.13.1 with Keras DL libraries. The area under curve (AUC), accuracy, sensitivity, and specificity values with 95% CIs were reported. The statistical analysis was performed by using scikit-learn libraries in Python 3.7.

RESULTS: A total of 1337 RA ultrasound images were acquired from 208 patients, the number of images is 313, 657, 178, and 189 in OESS Grade L0, L1, L2, and L3, respectively. In Classification Scenario 1 SP-no versus SP-yes, three experiments with region of interest of size 192 × 448 (Group 1), 96 × 224 (Group 2), and 96 × 224 stacked with pre-segmented annotated mask of SP area (Group 3) as input achieve an AUC of 0.863 (95% CI: 0.809, 0.917), 0.861 (95% CI: 0.805, 0.916), and 0.886 (95% CI: 0.836, 0.936), respectively. In Classification Scenario 2 Healthy versus Diseased, experiments in Group 1, Group 2 and Group 3 achieve an AUC of 0.848 (95% CI: 0.799, 0.896), 0.864 (95% CI: 0.819, 0.909), and 0.916 (95% CI: 0.883, 0.952), respectively.

CONCLUSION: We combined DenseNet model with ultrasound images for RA condition assessment. The feasibility of using DL to create an automatic RA condition classification system was also demonstrated. The proposed method can be an alternative to the initial screening of RA patients.

PMID:35038176 | DOI:10.1002/jcu.23143

Folia Histochem Cytobiol. 2022 Jan 17. doi: 10.5603/FHC.a2022.0003. Online ahead of print.

ABSTRACT

INTRODUCTION: . Apoptosis is a key process during normal trophoblastic development and, consequently, the whole gestation. However, in trophoblastic differentiation in spontaneous abortions apoptosis has been hardly investigated. Therefore, the aim of the study was to investigate the correlation between apoptotic frequency in trophoblast and spontaneous abortion incidences.

MATERIAL AND METHODS: A total of 72 trophoblastic tissue samples were immunohistochemically examined. 42 of 72 derived from first-trimester spontaneous abortions and the remaining 30 from elective terminations during the same trimester of pregnancy. TUNEL assay and M30 marker were used for apoptosis evaluation by immunohistochemistry.

RESULTS: Comparative study of tissues from spontaneous abortions and elective pregnancy terminations demonstrated increased expression of both apoptotic markers in tissues derived from spontaneous abortions compared to normal pregnancies. In addition, statistical analysis correlated maternal age and gravidity with increased spontaneous abortion incidences. Moreover, both M30 and TUNEL staining were significantly correlated with maternal age and primigravidity in spontaneous abortion cases.

CONCLUSIONS: Our data proved that elevated apoptotic activity during the first pregnancy trimester is clearly involved in spontaneous abortions. Moreover, two well-established apoptotic markers revealed high statistical significance in the evaluation of post-abortive tissues.

PMID:35038161 | DOI:10.5603/FHC.a2022.0003