Category: Nevin Manimala

J Phys Chem Lett. 2021 Jul 1:6227-6243. doi: 10.1021/acs.jpclett.1c01357. Online ahead of print.

ABSTRACT

Machine learning (ML) is quickly becoming a premier tool for modeling chemical processes and materials. ML-based force fields, trained on large data sets of high-quality electron structure calculations, are particularly attractive due their unique combination of computational efficiency and physical accuracy. This Perspective summarizes some recent advances in the development of neural network-based interatomic potentials. Designing high-quality training data sets is crucial to overall model accuracy. One strategy is active learning, in which new data are automatically collected for atomic configurations that produce large ML uncertainties. Another strategy is to use the highest levels of quantum theory possible. Transfer learning allows training to a data set of mixed fidelity. A model initially trained to a large data set of density functional theory calculations can be significantly improved by retraining to a relatively small data set of expensive coupled cluster theory calculations. These advances are exemplified by applications to molecules and materials.

PMID:34196559 | DOI:10.1021/acs.jpclett.1c01357

Clin Implant Dent Relat Res. 2021 Jul 1. doi: 10.1111/cid.13028. Online ahead of print.

ABSTRACT

BACKGROUND: Rough and/or plasma-activated abutments seem to be able to increase soft tissue adhesion and stability; however, limited evidence is available about bacterial contamination differences.

PURPOSE: The aim was to investigate the oral microbiota on four dental abutments with different surfaces by quantitative real-time polymerase chain reaction (qRT-PCR) and culturomic approach.

METHODS: Forty patients needing a single implant rehabilitation were involved in the study. Forty healing abutments, especially designed for the study, were divided into four groups according to the surface topography (1. machined [MAC], 2. machined plasma of argon treated [plasmaMAC], 3. ultrathin threaded microsurface [UTM], 4. UTM plasma of argon treated [Plasma UTM]). Random assignment was performed according to predefined randomization tables. All patients underwent surgical intervention for implant and contextual healing abutment positioning. After 2 months of healing, a sterile cotton swab was used for microbiological sampling for culturomics, while sterile paper points inserted into the sulcus were used for qRT-PCR.

RESULTS: At the end of the study, 36 patients completed all procedures and a total of 36 abutments (9 per group) were analyzed. qRT-PCR retrieved data for 23 bacterial species whereas culturomics revealed the presence of 74 different bacteria, most of them not routinely included into oral cavity microbiological kits of analysis or never found before in the oral microenvironment. No statistically significant differences emerged analyzing the four different surfaces (p = 0.053). On the contrary, higher total and specific bacterial counts were detected in the plasma-treated surfaces compared to the untreated ones (p = 0.021).

CONCLUSIONS: Abutments with different topographies and surface treatments resulted contaminated by similar oral bacterial flora. Abutments with moderately rough surface were not associated with a greater bacterial adhesion compared to machined ones. Conversely, more bacteria were found around plasma-treated abutments. Furthermore, data reported suggested to include new species not previously sought in the routine analyses of the oral bacterial microflora.

PMID:34196453 | DOI:10.1111/cid.13028

Res Synth Methods. 2021 Jul 1. doi: 10.1002/jrsm.1512. Online ahead of print.

ABSTRACT

We introduce and evaluate three tests for publication selection bias based on excess statistical significance. The proposed tests incorporate heterogeneity explicitly in the formulas for expected and excess statistical significance. We calculate the expected proportion of statistically significant findings in the absence of selective reporting or publication bias based on each study’s standard error and meta-analysis estimates of the mean and variance of the true-effect distribution. Comparing the expected to the observed proportion of statistically significant results leads to a simple proportion of statistical significance test (PSST). Alternatively, we propose a direct test of excess statistical significance (TESS). We also combine these two tests of excess statistical significance (TESSPSST). Simulations show that these excess statistical significance tests often outperform the conventional Egger test for publication selection bias and the three-parameter selection model. This article is protected by copyright. All rights reserved.

PMID:34196473 | DOI:10.1002/jrsm.1512

Pediatr Pulmonol. 2021 Jul 1. doi: 10.1002/ppul.25556. Online ahead of print.

ABSTRACT

PURPOSE: To investigate the characteristic thoracic MDCT findings of pathologically proven combined congenital lung lesion consisting of bronchial atresia (BA) and congenital pulmonary airway malformation (CPAM) in children.

MATERIALS AND METHODS: All pediatric patients (age ≤ 18 years) with a known pathological diagnosis of a combined BA-CPAM congenital lung lesion, who underwent thoracic MDCT studies from January 2011 to January 2021 were included. Two pediatric radiologists independently evaluated thoracic MDCT studies for the presence of abnormalities in the lung, including nodule, mass, cyst, ground-glass opacity (GGO), and consolidation. When a lung abnormality was present, the number, size, composition (solid, cystic, or combination of both), borders (well-circumscribed vs. ill-defined), contrast enhancement pattern (non-enhancement vs. enhancement), and location (laterality, and lobar distribution) were also evaluated. Interobserver agreement between two independent reviewers was evaluated with kappa statistics.

RESULTS: Eighteen contrast-enhanced thoracic MDCT studies from 18 individual pediatric patients (8 males (44%) and 10 females (56%); mean age: 4.9 months; SD: 2.6; range: 1 – 10 months) with a pathological diagnosis of combined BA-CPAM congenital lung lesion comprised the final study population. The most frequent MDCT finding of combined BA-CPAM congenital lung lesion in children was a solitary (18/18; 100%), well-circumscribed (18/18; 100%), both solid and cystic (17/18; 94%) lesion with non-enhancing (17/17; 100%) nodule, representing the underlying BA component, adjacent to a well-circumscribed multicystic mass (18/18; 100%), representing the underlying CPAM component. This combined congenital lung lesion occurred in all lobes with similar frequency. There was almost perfect interobserver kappa agreement between the two independent reviewers for detecting abnormalities on thoracic MDCT studies (k = 0.98).

CONCLUSION: The characteristic thoracic MDCT findings of a combined BA-CPAM congenital lung lesion are a solitary, well-circumscribed solid and muticystic mass, with a non-enhancing nodule, representing the BA component, adjacent to a cystic mass, representing the CPAM component. Accurate recognition of these characteristic MDCT findings of combined BA-CPAM congenital lung lesion has great potential to help differentiate this combined congenital lung lesion from other thoracic pathology in children. This article is protected by copyright. All rights reserved.

PMID:34196512 | DOI:10.1002/ppul.25556

Laryngoscope. 2021 Jul 1. doi: 10.1002/lary.29711. Online ahead of print.

ABSTRACT

OBJECTIVES/HYPOTHESIS: Sinonasal Outcomes Test-22 (SNOT-22) is used widely as a patient-reported sinonasal quality-of-life (QOL) instrument for endoscopic endonasal pituitary surgery. However, it has never been validated in this population. This study explores the psychometric validity of SNOT-22 to determine if it is a valid scale in patients undergoing endoscopic pituitary surgery.

STUDY DESIGN: Multicenter prospective trial.

METHODS: Adult patients (n = 113) with pituitary tumors undergoing endoscopic surgery were enrolled in a multicenter study. Patient-reported QOL was assessed using SNOT-22 and the Anterior Skull Base Nasal Inventory-12. Face validity, internal consistency, responsiveness to clinical change, test-retest reliability, and concurrent validity were determined using standard statistical methods.

RESULTS: Internal consistency using Cronbach’s alpha at baseline and 2 weeks postoperatively were 0.911 and 0.922, indicating SNOT-22 performed well as a single construct. Mean QOL scores were significantly worse at 2 weeks than baseline (16.4 ± 15.1 vs. 23.1 ± 16.4, P < .001), indicating the scale is responsive to clinical change. However, only 11/22 items demonstrated significant changes in mean scores at 2 weeks. Correlation between scores at 2 and 3 weeks was high, suggesting good test-retest reliability, r(107) = 0.75, P < .001. Factor analysis suggests the five-factor solution proposed for the SNOT-22 in rhinosinusitis patients is not valid in pituitary surgery patients.

CONCLUSIONS: The SNOT-22 is a valid QOL instrument in patients undergoing endoscopic pituitary surgery. However, because it includes 22 items, can be applied only as a single construct, 50% of the items do not demonstrate changes after surgery, and is not as sensitive to change as other scales, shorter instruments developed specifically for this patient population may be preferable.

LEVEL OF EVIDENCE: II Laryngoscope, 2021.

PMID:34196397 | DOI:10.1002/lary.29711

Fam Process. 2021 Jul 1. doi: 10.1111/famp.12684. Online ahead of print.

ABSTRACT

The objective of this study was to evaluate the effect that participating in support groups for caregivers has on the quality of life and psychotropic drug use of family caregivers of adults with limitations in activities of daily living. A controlled quasi-experimental longitudinal design was used with 134 caregivers (64 in the experimental group and 70 in the control group). The outcomes were health-related quality of life (EuroQol 5D3L test) and psychotropic drug use (no/yes). The analyses were performed using SPSS and R statistical software. An interaction was observed between the condition and the level of limitations in activities of daily living of the care receiver, having an effect on the caregiver’s psychotropic drug use (p = 0.003), with this use being lower among caregivers who attend support groups when their relatives present fewer limitations in activities of daily living. Moreover, the quality of life was higher in the post-test in the experimental group (B = 8.66, p = 0.015). In conclusion, support groups could improve the caregiver’s quality of life and decrease psychotropic drug use when the care receiver has low limitations in activities of daily living.

PMID:34196399 | DOI:10.1111/famp.12684

Adv Respir Med. 2021;89(3):262-267. doi: 10.5603/ARM.a2021.0053.

ABSTRACT

INTRODUCTION: Obstructive sleep apnea (OSA) is highly prevalent. Home sleep apnea testing (HSAT) for OSA is rapidly expanding because of its cost effectiveness in the diagnosis of OSA. Type 3 portable monitors are used for this purpose. In most cases, these devices contain an algorithm for automatic scoring of events. We propose to study the accuracy of the automatic scoring algorithm in our population in order to compare it with the manually edited scoring of Nox-T3®.

MATERIAL AND METHODS: For five months, a prospective study was performed. Patients were randomly distributed to the available HSAT devices. We collected the data of patients who performed HSAT with Nox-T3®. We used normality plots, the Spearman correlation, the Wilcoxon signed-rank test, and Bland-Altman plots.

RESULTS: The sample consisted of 283 participants. The average manual apnea and hypopnea index (AHI) was 23.7 ± 22.1 events/h. All manual scores (AHI, apnea index, hypopnea index, and oxygen desaturation index) had strong correlations with their respective automated scores. When AHI > 15 and AHI > 30 the difference between the values of this index (automatic and manual) was not statistically significant. Also, for AHI values > 15 the mean difference between the two scoring methods was 0.17 events/h. For AHI values > 30, this difference was – 1.23 events/h.

CONCLUSIONS: When AHI is < 15, there may be a need for confirmation of automatic scores, especially in symptomatic patients with a high pretest probability of OSA. But, for patients with AHI > 15, automatic scores obtained from this device seem accurate enough to diagnose OSA in the correct clinical setting.

PMID:34196378 | DOI:10.5603/ARM.a2021.0053

Adv Respir Med. 2021;89(3):277-283. doi: 10.5603/ARM.a2021.0056.

ABSTRACT

BACKGROUND: Intelligent volume-assured pressure support (iVAPS) is a new noninvasive ventilation (NIV) mode that can automatically adjust pressure support to deliver effective ventilation. Our aim was to compare treatment efficacy and level of satisfaction between auto-titrating expiratory positive airway pressure (auto-EPAP) and fixed expiratory positive airway pressure (fixed-EPAP) during iVAPS treatment in stable hypercapnic chronic obstructive pulmonary disease (COPD) patients.

MATERIAL AND METHODS: In this prospective single-blinded, randomized study, 50 patients with chronic stable hypercapnia (COPD) who met the study criteria were randomized into a group I treated with auto-EPAP and a group II who received fixed-EPAP during iVAPS treatment for 5 consecutive days. The patients’ characteristics, arterial blood gases, and lung function test were recorded. Numeric rating scale (NRS), dyspnea and comfort scale were obtained. The study subjects were evaluated and followed up after initiating therapy for 5 consecutive days. Outcome measures were recorded at baseline (T0) and after three (T1) and five (T2) days of each consecutive period All parameters were collected and statistically analyzed.

RESULT: No significant differences were found regarding age, sex, or BMI between the both groups. It was noted that daytime PaCO2 decreased significantly over the follow-up period in the group I patients treated with auto-EPAP as compared with fixed-EPAP. Regarding the patient comfort and dyspnea during iVAPS treatment, dyspnea sensation was significantly lower with auto-EPAP 7.9 ± 1.8 (T0) vs 3.5 ± 1.1 (T2), p = 0.001 and fixed-EPAP 7.7 ± 1.9 (T0) vs 3.4 ± 1.6 (T2), p = 0.001, but no significance was reached between the both groups. However, auto-EPAP demonstrated significant improvement in comfort when compared with fixed-EPAP modality. However, the overall satisfaction of the patients receiving auto-EPAP modality was significantly increased. Mean tidal volume tended to be higher in auto-EPAP 698 ± 213 mL compared with 628 ± 178 mL in fixed-EPAP (p = 0.001). The air leak was significantly lower in auto-adjusting mode (2.5 ± 1.3 vs 3.7 ± 2.2 L/ min) in fixed-EPAP modality.

CONCLUSION: Auto-titrating NIV mode may provide additional benefit in decreasing PaCO2 more efficiently and improve patient comfort and satisfaction.

PMID:34196380 | DOI:10.5603/ARM.a2021.0056

Adv Respir Med. 2021;89(3):247-253. doi: 10.5603/ARM.a2021.0060.

ABSTRACT

INTRODUCTION: The procedure of lung parenchyma resection may result in impairment of physical capacity and quality of life. In patients with operable non-small cell lung cancer (NSCLC), lobectomy is an elective procedure. Chronic obstructive pulmonary disease (COPD) is a common coexisting condition in patients with NSCLC. Effectiveness of post-operative pulmonary rehabilitation (PR) in patients who underwent lobectomy due to NSCLC and suffering from COPD as compared to individuals without COPD has not been determined yet. The aim of the study was to compare effectiveness of post-operative PR in patients with COPD after lobectomy due to NSCLC (COPD[+] L [+]) with individuals with COPD without lung parenchyma resection (COPD(+) L(-)) and those who underwent lobectomy due to NSCLC and not suffering from COPD (COPD[-] L[+]).

MATERIAL AND METHODS: Thirty-seven patients with non-small cell lung cancer (21 patients with and 16 patients without COPD) who underwent lobectomy and 29 subjects with COPD referred to the Lung Diseases Treatment and Rehabilitation Centre in Lodz in 2018-2019 were included in this retrospective analysis. The patients participated in a 3-week inpatient pulmonary rehabilitation (PR) program which included breathing exercises, physical workout, relaxation exercises, education, psychological support and nutrition consulting. The evaluation included lung function measurements, six-minute walking test (6MWT) and the St. George’s Respiratory Questionnaire (SGRQ) score. The results obtained before the rehabilitation were compared to those achieved after the 3-week PR program and compared between the study groups.

RESULTS: A significant increase in the distance covered during 6MWT was observed in all the three groups studied: COPD(+) L(+) (Δ = 62.52 ± 14.58 m); COPD(-) L(+) (Δ = 73.67 ± 11.58 m); and COPD(+) L(-) (Δ = 59.93 ± 10.02 m) (p < 0.001 for all). Similarly, a statistically and clinically significant improvement in the total SGRQ score was recorded: COPD(+) L(+) ∆ = -12.05 ± 3.96 points; p < 0.05 and COPD(-) L(+) ∆ = -12.30 ± 4.85 points; p < 0.01 and COPD(+) (L-) ∆= -14.07 ± 3.36 points (p < 0.001). No significant differences in the outcome improvement between the study groups were identified.

CONCLUSIONS: The results of the study show that COPD(+) L(+) patients gained benefits from post-operative PR comparable to COPD(+) L(-) and COPD(-) L(+) subjects by improving their physical capacity and quality of life.

PMID:34196376 | DOI:10.5603/ARM.a2021.0060

Vasc Endovascular Surg. 2021 Jul 1:15385744211026452. doi: 10.1177/15385744211026452. Online ahead of print.

ABSTRACT

OBJECTIVES: Patients often require multiple access re-interventions to improve fistula patency and the overall usable lifespan of autogenous arteriovenous fistula (aAVF). There is no consensus on the appropriate number of re-interventions after which an access should be abandoned and new access placed. We evaluated whether repeated endovascular interventions for failing/failed aAVF are worthwhile or futile.

METHODS: A retrospective review was performed on aAVFs created between 2009-2014. Fistula function was evaluated until January 2017. Functional fistula patency (FFP) was defined as the total time of functional fistula use for hemodialysis, from time of cannulation to time of measurement or fistula abandonment, including all interventions performed to maintain/reestablish patency. Primary outcomes were FFP duration and number of post-dialysis interventions.

RESULTS: The study included 163 patients. Mean age was 67 (SD = 15.03). The only variable statistically different between functional fistulas and abandoned fistulas was obesity (p = 0.03). At the end of the study period, 145 (89.0%) patients continued to have functional fistulas, and 73 (44.8%) patients died, but had functional fistulas at time of death. Median FFP for the functional group was 3.18 years (range 0.01-7.01 years) and median number of interventions was 1 (range 0-13). In 18 patients (11%), the fistula was abandoned, most commonly due to thrombosis (47.1%), followed by infection (23.5%). No fistula was abandoned because of an unacceptable rate of reintervention. Median FFP in the abandoned group was 0.91 years (range 0.03-5.30 years), and median number of interventions was 0 (range of 0-5).

CONCLUSIONS: Through repeated interventions on aAVFs, none of the patients in our study exhausted all hemodialysis access options prior to transplantation, death or loss to follow-up. These results may indicate repeated and/or more frequent revisions do not negatively affect the FFP nor do they increase the overall risk for abandonment of aAVFs.

PMID:34196244 | DOI:10.1177/15385744211026452