Category: Nevin Manimala

J Psychosom Res. 2021 Mar 16;144:110420. doi: 10.1016/j.jpsychores.2021.110420. Online ahead of print.

ABSTRACT

OBJECTIVE: Wuhan, the epicentre of the coronavirus diseases (COVID-19) outbreak, has been locked down on January 23, 2020. We conducted a study among the lay public in Wuhan to access their support, understanding of, compliance with, and the psychological impacts of the quarantine.

METHODS: We conducted a cross-sectional, online-based survey study between January 28, 2020, and February 2, 2020 among the adult lay public in Wuhan to access their support, understanding of, compliance with, and the psychological impacts of the quarantine. Multivariable logistic analysis was used to identify factors associated with psychological impacts.

RESULTS: Among the 4100 participants investigated, a total of 15.9% were compliant with all the five household prevention measures, whereas 74.4% were compliant with all the three community prevention measures investigated. By demographics, participants of younger age, higher income, residing in an urban area, knowing neighbors infected with COVID-19 reported significantly higher psychological impact score. Participants with a lower level of support for quarantine were more likely to have a higher psychological impact score (OR = 1.45, 95% CI 1.07-1.96). Participants with a lower level of compliance with preventive measures (score of 0-19) reported higher psychological impact (OR = 1.40, 95% CI 1.22-1.60 vs. score 20-24). Participants who had been out of house socializing and attended public events expressed higher psychological impact.

CONCLUSIONS: Support, understanding of the rationale for quarantine are essential in ensuring appropriate psychological well-being during the quarantine. Improvements in compliance with preventive measures are highly warranted and may bring about a reduction in psychological distress.

PMID:33770568 | DOI:10.1016/j.jpsychores.2021.110420

J Mech Behav Biomed Mater. 2021 Mar 20;118:104478. doi: 10.1016/j.jmbbm.2021.104478. Online ahead of print.

ABSTRACT

Ag-doped Cr/DLC coatings were deposited on medical grade 316 LVM stainless steel using DC magnetron sputtering. Morphological study of the coating indicated the formation of island of Ag clusters owing to the inability of Ag to form carbides, which is also corroborated from the XRD analysis. The composite coating showcased elastic nature suggestive from the p-h curve obtained from the nanoindentation test. However, the coating possesses 33% ductility, which is an important virtue for stress relieving attributed to Ag in the carbon matrix. The coating registered improved adhesion due to Cr₃C₂ carbide formation in the interlayer. The composite coating was subjected to lubricated sliding in physiological fluid against carbon fiber reinforced PEEK (CFRPEEK) friction pair to realize a closer scenario to hip implant articulation. A lubricious film of Ag with scattered particles of PEEK was formed in the sliding interface resulting in a long run-in process during sliding. The composite coating suffered mild wear on the Ag-doped DLC top layer with few gullies of wear scar deep into the interlayer due to graphitization of carbon in the film. A statistically significant difference was observed in the hardness, H³/E², elastic work, and plastic work; however, there was no statistically significant difference in H/E attribute between the unworn and worn surface. What is more, Raman spectra of the worn (I_D/I_G = 1.9 ± 0.2) and unworn surface (I_D/I_G = 2.1 ± 0.1) were indicative of no significant loss in the structural integrity of the composite coating.

PMID:33770586 | DOI:10.1016/j.jmbbm.2021.104478

Epilepsy Behav. 2021 Mar 23;118:107919. doi: 10.1016/j.yebeh.2021.107919. Online ahead of print.

ABSTRACT

Insular epilepsy is increasingly recognized in epilepsy surgery centers. Recent studies suggest that resection of an epileptogenic zone that involves the insula as a treatment for drug-resistant seizures is associated with good outcomes in terms of seizure control. However, despite the existing evidence of a role of the insula in emotions and affective information processing, the long-term psychological outcome of patients undergoing these surgeries remain poorly documented. A group of 27 adults (18 women) who underwent an insulo-opercular resection (in combination with a part of the temporal lobe in 10, and of the frontal lobe in 5) as part of epilepsy surgery at our center between 2004 and 2019 completed psychometric questionnaires to assess depression (Beck Depression Inventory – 2nd edition; BDI-II), anxiety (State-Trait Anxiety Inventory, Trait Version; STAI-T), and quality of life (Patient Weighted Quality of Life In Epilepsy; QOLIE-10-P). Scores were compared to those of patients who had standard temporal lobe epilepsy (TLE) surgery with similar socio-demographic and disease characteristics. Seizure control after insular epilepsy surgery was comparable to that observed after TLE surgery, with a majority of patients reporting being seizure free (insular: 63.0%; temporal: 63.2%) or having rare disabling seizures (insular: 7.4%; temporal: 18.4%) at the time of questionnaire completion. Statistical comparisons revealed no significant group difference on scores of depression, anxiety, or quality of life. Hemisphere or extent of insular resection had no significant effect on the studied variables. In the total sample, employment status and seizure control, but not location of surgery, significantly predicted quality of life. Self-reported long-term psychological status after insulo-opercular resection as part of epilepsy surgery thus appears to be similar to that observed after TLE surgery, which is commonly performed in epilepsy surgery centers.

PMID:33770610 | DOI:10.1016/j.yebeh.2021.107919

Lancet Neurol. 2021 Mar 23:S1474-4422(21)00027-2. doi: 10.1016/S1474-4422(21)00027-2. Online ahead of print.

ABSTRACT

BACKGROUND: The European Friedreich’s Ataxia Consortium for Translational Studies (EFACTS) investigates the natural history of Friedreich’s ataxia. We aimed to assess progression characteristics and to identify patient groups with differential progression rates based on longitudinal 4-year data to inform upcoming clinical trials in Friedreich’s ataxia.

METHODS: EFACTS is a prospective, observational cohort study based on an ongoing and open-ended registry. Patients with genetically confirmed Friedreich’s ataxia were seen annually at 11 clinical centres in seven European countries (Austria, Belgium, France, Germany, Italy, Spain, and the UK). Data from baseline to 4-year follow-up were included in the current analysis. Our primary endpoints were the Scale for the Assessment and Rating of Ataxia (SARA) and the activities of daily living (ADL). Linear mixed-effect models were used to analyse annual disease progression for the entire cohort and subgroups defined by age of onset and ambulatory abilities. Power calculations were done for potential trial designs. This study is registered with ClinicalTrials.gov, NCT02069509.

FINDINGS: Between Sept 15, 2010, and Nov 20, 2018, of 914 individuals assessed for eligibility, 602 patients were included. Of these, 552 (92%) patients contributed data with at least one follow-up visit. Annual progression rate for SARA was 0·82 points (SE 0·05) in the overall cohort, and higher in patients who were ambulatory (1·12 [0·07]) than non-ambulatory (0·50 [0·07]). ADL worsened by 0·93 (SE 0·05) points per year in the entire cohort, with similar progression rates in patients who were ambulatory (0·94 [0·07]) and non-ambulatory (0·91 [0·08]). Although both SARA and ADL showed slightly greater worsening in patients with typical onset (symptom onset at ≤24 years) than those with late onset (symptom onset ≥25 years), differences in progression slopes were not significant. For a 2-year parallel-group trial, 230 (115 per group) patients would be required to detect a 50% reduction in SARA progression at 80% power: 118 (59 per group) if only individuals who are ambulatory are included. With ADL as the primary outcome, 190 (95 per group) patients with Friedreich’s ataxia would be needed, and fewer patients would be required if only individuals with early-onset are included.

INTERPRETATION: Our findings for stage-dependent progression rates have important implications for clinicians and researchers, as they provide reliable outcome measures to monitor disease progression, and enable tailored sample size calculation to guide upcoming clinical trial designs in Friedreich’s ataxia.

FUNDING: European Commission, Voyager Therapeutics, and EuroAtaxia.

PMID:33770527 | DOI:10.1016/S1474-4422(21)00027-2

Clin Biomech (Bristol, Avon). 2021 Mar 15;84:105323. doi: 10.1016/j.clinbiomech.2021.105323. Online ahead of print.

ABSTRACT

BACKGROUND: Two populations commonly presenting with equinus gait are Idiopathic Toe-Walkers and children with Cerebral Palsy. Surgical intervention to treat equinus is defined by three zones. Zone three surgery, performed at the Achilles tendon, is most commonly used clinically. There is however, evidence from simulation studies that zone two surgery, performed at the muscle belly, might provide better functional outcomes. The purpose of this study was to investigate the effect of zone two calf-lengthening on post-operative gait in these populations.

METHODS: A retrospective audit of the Queensland Children’s Motion Analysis Service database identified 17 toe-walkers (mean age 10.13 (SD 2.625)) and 11 Cerebral Palsy (mean age 9.72 (SD 4.04)) participants that received calf-lengthening surgery for plantarflexion contracture and had pre- and post-surgery 3D gait analysis. Inverse kinematics, dynamics, and muscle analysis were performed in OpenSim (v3.3) using a modified gait2392 model. Pre to post-surgery comparisons were performed in MATLAB using statistical parametric mapping. Dependent variables included ankle kinematics, powers and muscle-tendon length estimates.

FINDINGS: The primary outcome of this study was that ankle dorsiflexion increased in both Idiopathic Toe Walking and Cerebral Palsy groups post-calf lengthening across 90% and 85% of the gait cycle respectively. There was an increase in modelled muscle-tendon lengths, specifically in the medial gastrocnemius, of 78% (toe-walkers), and 100% (Cerebral Palsy) of the gait cycle. Power generation during push-off was not affected.

INTERPRETATION: Overall, the results appear to support the efficacy of zone 2 calf-lengthening for children with Cerebral Palsy and Idiopathic Toe Walking.

PMID:33770533 | DOI:10.1016/j.clinbiomech.2021.105323

Clin Imaging. 2021 Mar 19;78:60-63. doi: 10.1016/j.clinimag.2021.02.040. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate whether, with access to free screening services, uninsured minority women in NYC are able to successfully manage existing barriers to breast cancer screening.

METHODS: This is a retrospective cohort study, with permission to use de-identified data received from Project Renewal’s ScanVan in 2019. Project Renewal ScanVan provides clinical breast exams, mammograms, and health education to low-income women. The screening mammograms were conducted in the ScanVan and read by a board-certified radiologist. The electronic medical records were reviewed with respect to the patients’ BI-RADS category, insurance status, race, and age. Descriptive statistics were performed and cancer detection rate, recall rate, and positive predictive values (PPV1, PPV2, PPV3) were calculated.

RESULTS: In 2019, 66% (2499 of 3745) of patients who used the ScanVan were Hispanic & African American. 43% (1627 of 3745) of the women were uninsured, 15% (579 of 3745) of the women had Medicare, and 18% (676 of 3745) classified as other. 17 out of 3745 patients screened received a new diagnosis of breast cancer, corresponding to a cancer detection rate of 4.5/1000 screened. 258 were recalled, corresponding with a recall rate of 7%. The PPV1 was 6.5% (17/258); PPV2 was 29.8% (17/57); and PPV3 was 34% (17/50).

CONCLUSION: Barriers to breast cancer screening include lack of medical insurance, limited access to care, and the absence of a primary care physician. The mobile mammography screening van successfully overcame such barriers, providing uninsured women from racial minority groups with vital breast cancer screening and follow up care.

PMID:33770557 | DOI:10.1016/j.clinimag.2021.02.040

Arthritis Care Res (Hoboken). 2021 Mar 26. doi: 10.1002/acr.24607. Online ahead of print.

ABSTRACT

OBJECTIVES: To develop and validate a composite RA disease activity index using optical spectral transmission (OST)-scores obtained with the HandScan replacing tender and swollen joint counts.

METHODS: RA patients from a single centre routinely undergoing HandScan measurements and at least one concurrent OST-score and DAS28 were included. Data was extracted from medical records. Linear regression analyses with DAS28 as outcome were performed to create a disease activity index (DAS-OST). OST-score, ESR and patient global assessment (PGA-)VAS, gender, age, disease duration and RF-status were evaluated as independent variables. Final models were derived, based on statistical significance of coefficients and model fit. Of the data, 2/3 was used for development and 1/3 for validation; external validation was performed in a cohort from another centre. Agreement between DAS-OST and DAS28 was assessed using the Bland-Altman plot method and intra-class correlation coefficient (ICC). Diagnostic value of DAS-OST was determined for established definitions of remission, and low (L), and high (H) disease activity (DA).

RESULTS: Data of 3358 observations from 1505 unique RA patients were extracted. DAS-OST was defined as: -0.44 + OST*0.03 + male*-0.11 + LN(ESR)*0.77 + PGA-VAS*0.03. The ICC between DAS-OST and DAS28 were 0.88 (95%CI 0.87-0.90) and 0.82 (95%CI 0.75-0.86) and measurement errors 0.58 and 0.87 in internal and external validation, respectively. Sensitivity for remission, LDA and HDA were 79%, 91%, 43%, and specificity 92%, 80%, 96% in external validation.

CONCLUSION: Using the HandScan, RA disease activity can be accurately estimated if combined with ESR, PGA-VAS and gender into a disease activity index (DAS-OST).

PMID:33770421 | DOI:10.1002/acr.24607

J Neurooncol. 2021 Mar 26. doi: 10.1007/s11060-021-03746-2. Online ahead of print.

ABSTRACT

INTRODUCTION: Esthesioneuroblastoma (ENB) is an uncommon primary sinonasal tumor which can extend intracranially. Exactly how to classify them pathologically still remains discrepant; the Hyams grading system, for example, has not been universally adopted. This individual patient data (IPD) meta-analysis aimed to investigate the prognostic implication of each Hyams grade on patient outcomes.

METHODS: We accessed two electronic databases including PubMed and Web of Science. Raw patient data from potential articles were extracted. To examine the associations of various clinicopathological factors with the Hyams grades, we utilized Chi-square, t-test, and Mann-Whitney, as appropriate. Log-rank test and Cox regression analysis were used to elucidate the impact of the Hyams grades on recurrence-free survival (RFS), metastasis-free survival (MFS), and overall survival (OS) of ENB patients.

RESULTS: We included 33 studies with 492 ENB patients. We found significant associations of Kadish stages, Dulguerov stages, rates of recurrence, metastasis, and patient mortality with Hyams grade. Log-rank tests and Cox regression models demonstrated significant differences in RFS and OS of Hyams grade I – II, grade III, and grade IV patients. There was no statistical difference in RFS and OS of Hyams grade I and II. Radiotherapy was only effective in grade III – IV ENBs and chemotherapy showed no benefits to patients.

CONCLUSION: We verify that the Hyams grading system appears to be a reliable prognostic indicator to assess ENB patient outcomes. Consolidating the Hyams grading system into a three-tier system based on similar clinical outcomes of grades I and II may simplify this classification schema.

PMID:33770323 | DOI:10.1007/s11060-021-03746-2

Ann Nucl Med. 2021 Mar 26. doi: 10.1007/s12149-021-01608-5. Online ahead of print.

ABSTRACT

AIM: To evaluate the use of digital ¹⁸F-FDG PET/CT with small-voxels reconstruction for detecting in-transit metastases in melanoma patients with primary lesion located on the upper or lower limbs, in comparison with standard reconstruction and European Association of Nuclear Medicine Research limited (EARL)-compliant reconstruction mimicking former generation PET systems.

METHODS: Forty-six PET examinations acquired in list mode on a Vereos digital PET/CT system were reconstructed with (1) the standard reconstruction [2 iterations, 10 subsets (2i10s), point-spread function (PSF) modelling and time-of-flight enabled, no post-filtering and voxel size of 2 mm], (2) a small-voxel reconstruction using 1 mm voxels otherwise using the same parameters, (3) an EARL-compliant reconstruction mimicking a former generation system. Comparison of results across these reconstructions was made for a blind randomized review using a 3-point scale for the presence of in-transit metastases and image quality as well as for tumour-to-background (T/B) ratios and noise level in reference organs.

RESULTS: Seven of the thirty-two EARL-compliant images classified as negative moved to positive on 1mm_PSF images, and 5 of the 6 EARL-compliant images classified as indeterminate moved to positive on 1mm_PSF images (P = 0.01). Amongst a total of 20 PET examinations classified as positive using the 1mm_PSF reconstruction, fifteen were considered true positive, five false positive results occurred. Twenty-four patients with 1 mm PSF images were classified as negative, none of those under active surveillance experienced in-transit metastases during the 17 months following their PET examination. The positive likelihood ratio for the 1 mm reconstruction was much higher than that observed for EARL-compliant images (14.7 vs 7.82). Importantly, negative likelihood ratios for the 1 mm and 1mm_PSF reconstruction were almost perfect. Compared to EARL-compliant data, T/B ratios extracted from the 1mm_PSF showed a 2.84-fold increase (P < 0.001). A similar pattern of statistically significant increase was observed for noise level in organs of reference. Image quality for the torso was found to be significantly lower for 1mm_PSF reconstruction (P = 0.03). Image quality for the limbs was found to be better for 1mm_PSF (P < 0.001).

CONCLUSION: Digital PET with small-voxel reconstruction brings an additional value for the detection of in-transit metastases by reducing the number of indeterminate findings and making up for falsely negative scans using former generation PET systems. An acquisition encompassing lower or upper limbs as appropriate should be performed.

PMID:33770374 | DOI:10.1007/s12149-021-01608-5

Psychometrika. 2021 Mar 26. doi: 10.1007/s11336-021-09752-7. Online ahead of print.

ABSTRACT

In this article, we present the findings of an oral history project on the past, present, and future of psychometrics, as obtained through structured interviews with twenty past Psychometric Society presidents. Perspectives on how psychometrics should be practiced vary strongly. Some presidents are psychology-oriented, whereas others have a more mathematical or statistical approach. The originally strong relationship between psychometrics and psychology has weakened, and contemporary psychometrics has become a diverse and multifaceted discipline. The presidents are confident psychometrics will continue to be relevant but believe psychometrics needs to become better at selling its strong points to relevant research areas. We recommend for psychometrics to cherish its plurality and make its goals and priorities explicit.

PMID:33770319 | DOI:10.1007/s11336-021-09752-7