Category: Nevin Manimala

Lasers Surg Med. 2021 Aug 19. doi: 10.1002/lsm.23453. Online ahead of print.

ABSTRACT

OBJECTIVES: Skin rejuvenation with radiofrequency has been a widely used treatment modality for the safe and efficient remodeling of the dermis and revision of textural irregularities, achieved with minimal downtime. The efficacy of fractional radiofrequency (FRF) specifically for acne scarring has not been widely established. The objective of this clinical trial was to establish the efficacy and safety of FRF for moderate to severe acne scarring in a wide range of Fitzpatrick skin types using two different applicator tips to deliver energy to the skin (80-pin of up to 124 mJ/pin and 160-pin of up to 62 mJ/pin).

METHODS: Enrolled subjects received a series of three FRF treatments to the full face, each 4 weeks apart. A visual analog scale was utilized to assess pain of the treatment. Subject satisfaction questionnaires were completed at follow-up visits at 6 and 12 weeks post final treatment. Photographs were graded for change by three blinded evaluators using the Global Aesthetic Improvement Scale (GAIS).

RESULTS: Image sets of 23 enrolled subjects were assessed by blinded evaluation, showing a statistically significant improvement (p = 0.009) from the baseline visit to the 12-week follow-up on the GAIS for acne scarring. Subject satisfaction was high with subjects giving an average satisfaction score of 3.27 (“satisfied”) out of 4. Pain was “mild” as treatments were rated an average of 2.15 on a 10-point visual analog scale. The GAIS score of the 80-pin tip improved patients’ acne scars treated with that applicator by 1.06 points and 0.85 for the 160-pin tip. Ninety-five percent (95.5%) of subjects reported either a mild, moderate, or significant improvement to their treatment area. Ninety-one percent of subjects reported that they would recommend the treatment to a friend.

CONCLUSION: FRF produced a statistically significant improvement in acne scarring when assessed by independent blinded evaluators. No serious adverse events resulted from treatment by either applicator tip. Treatment pain was low and tolerable among subjects of all Fitzpatrick skin types. Subjects had high levels of satisfaction with the results.

PMID:34412150 | DOI:10.1002/lsm.23453

Stat Med. 2021 Aug 19. doi: 10.1002/sim.9167. Online ahead of print.

ABSTRACT

Statistical analysis of questionnaire data is often performed employing techniques from item-response theory. In this framework, it is possible to differentiate respondent profiles and characterize the questions (items) included in the questionnaire via interpretable parameters. These models are often crosssectional and aim at evaluating the performance of the respondents. The motivating application of this work is the analysis of psychometric questionnaires taken by a group of mothers at different time points and by their children at one later time point. The data are available through the GUSTO cohort study. To this end, we propose a Bayesian semiparametric model and extend the current literature by: (i) introducing temporal dependence among questionnaires taken at different time points; (ii) jointly modeling the responses to questionnaires taken from different, but related, groups of subjects (in our case mothers and children), introducing a further dependency structure and therefore sharing of information; (iii) allowing clustering of subjects based on their latent response profile. The proposed model is able to identify three main groups of mother/child pairs characterized by their response profiles. Furthermore, we report an interesting maternal reporting bias effect strongly affecting the clustering structure of the mother/child dyads.

PMID:34412151 | DOI:10.1002/sim.9167

J Clin Psychopharmacol. 2021 Aug 20. doi: 10.1097/JCP.0000000000001446. Online ahead of print.

ABSTRACT

PURPOSE/BACKGROUND: Antidepressants are among the most frequently prescribed medications during pregnancy and may affect fetal weight. Associations between antenatal antidepressant use and ultrasonographic measures of fetal development have rarely been examined. We hypothesized that the prescription of an antenatal antidepressant would be associated with lower estimated fetal weight (EFW).

METHODS/PROCEDURES: A retrospective analysis of routine ultrasonographic data extracted from electronic medical records was performed on a cohort of pregnant women with psychiatric diagnoses and grouped according to the presence of an antenatal antidepressant prescription (n = 32 antidepressant-prescribed and n = 44 antidepressant prescription-free). After stratifying for gestational age, comparisons included 13 ultrasonographic parameters, frequency of oligohydramnios and polyhydramnios and growth deceleration, and maternal serum protein markers assessed per routine care, including α-fetoprotein, free β-human chorionic gonadotropin, and unconjugated estriol levels, using t tests, nonparametric and Fisher tests, and effect sizes (ESs) were computed.

FINDINGS/RESULTS: No statistically significant EFW differences between groups at any time point were detected (P > 0.05). Antenatal antidepressant prescription was associated with lower femur length at weeks 33 to 40 (P = 0.046, ES = 0.75) and greater left ventricular diameter at weeks 25 to 32 (P = 0.04, ES = 1.18). No differences for frequency of oligohydramnios or polyhydramnios or growth deceleration were observed (P > 0.05). We did not detect group differences for maternal proteins (P > 0.05).

IMPLICATIONS/CONCLUSIONS: Our evidence suggested a lack of association between antenatal antidepressant prescription and lower EFW but indicated an association with lower femur length and greater left ventricular diameter in mid-late gestation. Future research should examine the clinical implications of these findings.

PMID:34412105 | DOI:10.1097/JCP.0000000000001446

PLoS One. 2021 Aug 19;16(8):e0255982. doi: 10.1371/journal.pone.0255982. eCollection 2021.

ABSTRACT

Milgram empirically showed that people knowing only connections to their friends could locate any person in the U.S. in a few steps. Later research showed that social network topology enables a node aware of its full routing to find an arbitrary target in even fewer steps. Yet, the success of people in forwarding efficiently knowing only personal connections is still not fully explained. To study this problem, we emulate it on a real location-based social network, Gowalla. It provides explicit information about friends and temporal locations of each user useful for studies of human mobility. Here, we use it to conduct a massive computational experiment to establish new necessary and sufficient conditions for achieving social search efficiency. The results demonstrate that only the distribution of friendship edges and the partial knowledge of friends of friends are essential and sufficient for the efficiency of social search. Surprisingly, the efficiency of the search using the original distribution of friendship edges is not dependent on how the nodes are distributed into space. Moreover, the effect of using a limited knowledge that each node possesses about friends of its friends is strongly nonlinear. We show that gains of such use grow statistically significantly only when this knowledge is limited to a small fraction of friends of friends.

PMID:34412110 | DOI:10.1371/journal.pone.0255982

J Occup Environ Med. 2021 Aug 18. doi: 10.1097/JOM.0000000000002357. Online ahead of print.

ABSTRACT

OBJECTIVE: To document Covid-19 sero-prevalence, prior testing, symptom experiences, and risk factors in a sample of community health center (CHC) workers.

METHODS: Descriptive statistics and log-binomial regression were used to analyze an electronic employee survey linked with Covid-19 antibody results. The sample included 378 employees who completed the survey; 325 had complete lab data.

RESULTS: The sero-positivity rate was 15.4%. One third of sero-positive participants had no previous Covid-19 symptoms or were unsure. Working on-site only and/or with direct patient contact was not associated with sero-positivity. Employees in their 20 s were more likely to test positive than employees ages 50+, controlling for sex, race, and region (PR = 2.96; p < .05).

CONCLUSIONS: With CHCs central to Covid-19 response and vaccination efforts, public health messaging should remind CHC workers, especially younger employees, of their risks of community-based exposure.

PMID:34412095 | DOI:10.1097/JOM.0000000000002357

J Clin Psychopharmacol. 2021 Aug 20. doi: 10.1097/JCP.0000000000001465. Online ahead of print.

ABSTRACT

PURPOSE/BACKGROUND: Numerous health authority approvals of esketamine nasal spray, combined with oral antidepressant, to treat depressive symptoms in adults with major depressive disorder and acute suicidal ideation or behavior were based on 2 identically designed, double-blind, phase 3 studies.

METHODS/PROCEDURES: Across both ASPIRE studies (NCT03039192, NCT03097133), patients (N = 456) were randomized to esketamine 84 mg or placebo nasal spray twice weekly for 4 weeks plus comprehensive standard of care, including hospitalization and newly initiated or optimized antidepressant(s). In post hoc analyses of pooled data, changes from baseline at 24 hours after the first dose in Montgomery-Åsberg Depression Rating Scale total score and Clinical Global Impression-Severity of Suicidality-Revised, in the full cohort and in subgroups, were analyzed using analysis of covariance.

FINDINGS/RESULTS: Esketamine plus standard of care demonstrated significantly greater improvement in Montgomery-Åsberg Depression Rating Scale total score versus placebo plus standard of care at 24 hours (least square mean difference [95% confidence interval], -3.8 [-5.75 to -1.89]) and at earlier (4 hours: -3.4 [-5.05 to -1.71]) and later time points (day 25: -3.4 [-5.36 to -1.36]). The between-group difference (95% confidence interval) for change in Clinical Global Impression-Severity of Suicidality-Revised at 24 hours was -0.20 (-0.43 to 0.04) for all patients and -0.31 (-0.61 to -0.01) for those with a history of suicide attempt. Common adverse events (≥20%) during esketamine treatment were dizziness, dissociation, nausea, somnolence, and headache.

IMPLICATIONS/CONCLUSIONS: Esketamine plus comprehensive standard of care rapidly reduces depressive symptoms in patients with major depressive disorder who have acute suicidal ideation or behavior, especially in those with a history of suicide attempt, providing a new treatment option for this particularly ill and vulnerable population.

PMID:34412104 | DOI:10.1097/JCP.0000000000001465

Folia Phoniatr Logop. 2021 Aug 19:1-9. doi: 10.1159/000517064. Online ahead of print.

ABSTRACT

INTRODUCTION: The effect of the continuous forced expiration action of players of wind instruments to produce sound, on the eustachian tube functions and the middle-ear resonance frequency (RF), has not been investigated in the literature to date. The aim of this study is to evaluate eustachian tube functions and the middle-ear RF of players of wind instruments.

METHODS: In this prospective case-control clinical study, a study group of 28 players of wind instruments in the orchestra (28 participants, 56 ears) and a control group of 34 volunteers (34 participants, 68 ears) were included. The eustachian function of wind instrument players in a symphony orchestra was measured using an automatic eustachian tube function test in acoustic tympanometry and the RF of the middle ear was determined in multifrequency tympanometry.

RESULTS: There was a statistically significant difference among the musicians, especially in players of woodwind instruments, in terms of dysfunction of the eustachian tubes (p = 0.048). In the musicians, the pre- and postperformance RF mean values for all ears were 925 and 1,020 Hz, respectively, and these were significantly different (p = 0.004).

CONCLUSION: This is the first study to uses multifrequency tympanometry to examine the middle-ear RF and eustachian tube function of wind instrument musicians in an orchestra. Eustachian tube dysfunction was found to be more prominent and a higher RF of the middle ear was seen after a performance, especially in players of wood wind instruments. However, the effect of these on the professional performance of players of wind instruments should be investigated in future work.

PMID:34412053 | DOI:10.1159/000517064

Psychiatr Genet. 2021 Aug 17. doi: 10.1097/YPG.0000000000000296. Online ahead of print.

ABSTRACT

INTRODUCTION: In humans the normal development of cortical regions depends on the complex interactions between a number of proteins that promote the migrations of neuronal precursors from germinal zones and assembly into neuronal laminae. ASTN2 is one of the proteins implicated in such a complex process. Recently it has been observed that ASTN2 also regulates the surface expression of multiple synaptic proteins resulting in a modulation of synaptic activity. Several rare copy number variants (CNVs) in ASTN2 gene were identified in patients with neurodevelopmental disorders (NDDs) including autism spectrum disorders (ASD), attention deficit-hyperactivity disorders and intellectual disability.

METHODS: By using comparative genomic hybridization array technology, we analyzed the genomic profiles of five patients of three unrelated families with NDDs. Clinical diagnosis of ASD was established according to the Statistical Manual of Mental Disorders, Fifth Edition (APA 2013) criteria.

RESULTS: We identified new rare CNVs encompassing ASTN2 gene in three unrelated families with different clinical phenotypes of NDDs. In particular, we identified a deletion of about 70 Kb encompassing intron 19, a 186 Kb duplication encompassing the sequence between the 5′-end and the first intron of the gene and a 205 Kb deletion encompassing exons 6-11.

CONCLUSION: The CNVs reported here involve regions not usually disrupted in patients with NDDs with two of them affecting only the expression of the long isoforms. Further studies will be needed to analyze the impact of these CNVs on gene expression regulation and to better understand their impact on the protein function.

PMID:34412080 | DOI:10.1097/YPG.0000000000000296

J Mech Behav Biomed Mater. 2021 Aug 12;123:104728. doi: 10.1016/j.jmbbm.2021.104728. Online ahead of print.

ABSTRACT

Artificial intelligence (AI) and machine learning (ML) are fascinating interdisciplinary scientific domains where machines are provided with an approximation of human intelligence. The conjecture is that machines are able to learn from existing examples, and employ this accumulated knowledge to fulfil challenging tasks such as regression analysis, pattern classification, and prediction. The horse biomechanical models have been identified as an alternative tool to investigate the effects of mechanical loading and induced deformations on the tissues and structures in humans. Many reported investigations into bone fatigue, subchondral bone damage in the joints of both humans and animals, and identification of vital parameters responsible for retaining integrity of anatomical regions during normal activities in all species are heavily reliant on equine biomechanical research. Horse racing is a lucrative industry and injury prevention in expensive thoroughbreds has encouraged the implementation of various measurement techniques, which results in massive data generation. ML substantially accelerates analysis and interpretation of data and provides considerable advantages over traditional statistical tools historically adopted in biomechanical research. This paper provides the reader with: a brief introduction to AI, taxonomy and several types of ML algorithms, working principle of a feedforward artificial neural network (ANN), and, a detailed review of the applications of AI, ML, and ANN in equine biomechanical research (i.e. locomotory system function, gait analysis, joint and bone mechanics, and hoof function). Reviewing literature on the use of these data-driven tools is essential since their wider application has the potential to: improve clinical assessments enabling real-time simulations, avoid and/or minimize injuries, and encourage early detection of such injuries in the first place.

PMID:34412024 | DOI:10.1016/j.jmbbm.2021.104728

Folia Phoniatr Logop. 2021 Aug 19:1-10. doi: 10.1159/000516225. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this study is quantitative assessment of nasalance for skeletal Class I (normative values), Class II, and III malocclusion in the English language for the North Indian population and to compare the normative values with the nasalance scores obtained from individuals with skeletal Class II and III malocclusion and to evaluate the normative values as a function of gender.

MATERIAL AND METHODS: The study was conducted on a total sample of 200 patients with 100, 50, and 50 in group 1 (control group, Skeletal Class I), group 2 (Skeletal Class II), and group 3 (Skeletal Class III), respectively. ANB angle (anteroposterior angle formed by point A, nasion, and point B) measured on lateral cephalogram was used to categorize the patients into 3 groups. The normative nasalance scores were compared for males and females in the control group. The nasalance scores of skeletal Class II and III subjects were compared to the combined normative scores of the control group. The NasalView was used for the objective assessment of nasalance. Oral syllables (/pa/and/pi/), nasal syllables (/ma/and/mi/), and 3 passages (Zoo passage, Rainbow passage, and Nasal sentences) were used to determine the nasalance scores.

RESULTS: The intragroup comparison of nasalance scores in group 1 showed statistically significant differences for different stimuli. The gender-related comparison showed no statistically significant differences in nasalance scores. The intergroup comparison of nasalance scores for skeletal malocclusion showed no statistically significant differences for different stimuli except statistically significant lower nasalance values for nasal sentences in group 3 compared to the control group.

CONCLUSION: The study concluded that the nasalance scores for nasal sentences in skeletal Class III malocclusion were significantly lower than in the control group and were not statistically significant between the 3 groups for all other stimuli.

PMID:34412052 | DOI:10.1159/000516225