Category: Nevin Manimala

Sleep Med. 2020 Aug 28;82:134-143. doi: 10.1016/j.sleep.2020.08.026. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate alterations in neurocognitive, attention, paediatric sleep questionnaire (PSQ) scores and whole brain white matter (WM) integrity between children with mild and severe obstructive sleep apnoea (OSA) according to sex and whether these changes are associated with OSA severity.

METHODS: Fifty-seven children (36 males and 21 females) diagnosed with OSA were recruited for this study. Children of both sexes were divided into mild (male-MG, female-MG) and severe (male-SG, female-SG) groups according to OSA severity. Polysomnography (PSG), neurocognitive, attention and PSQ tests were compared between groups by one-way samples analysis of variance (ANOVA) F test. Diffusion tensor imaging (DTI) was scanned using a 3T GE MRI scanner and analysed by Tract-based Spatial Statistics (TBSS). Spearman correlation was calculated between DTI Eigenvalues and clinical characteristics.

RESULTS: Compared to mild OSA patients, severe OSA patients presented greater severity of obstructive apnoea hypopnea index (OAHI), neurocognition, PSQ and attention tests in both male and female patients. Brain WM integrity in the male-SG, compared to the male-MG, demonstrated significantly reduced fractional anisotropy (FA) values in the right middle frontal gyrus and the right frontal sub-gyral regions and increased axial diffusivity (AD) values in the right inferior frontal gyrus, left parietal angular gyrus and sub-gyral regions, while no differences were found between the female-MG and female-SG. Alterations in male-SG brain regions were observably correlated with severity in male OSA patients.

CONCLUSIONS: The integrity of WM, which regulates autonomic, cognitive, and attention functions, is impaired in male, but not female, children with severe OSA.

PMID:33915429 | DOI:10.1016/j.sleep.2020.08.026

Neural Netw. 2021 Feb 28;140:336-343. doi: 10.1016/j.neunet.2021.01.017. Online ahead of print.

ABSTRACT

A differential-algebraic neural network (DANN) with delay (DDANN) is proposed. Firstly, the global existence and uniqueness theorems are established for a DDANN, respectively. Next, a new differential-algebraic inequality is established. Then, a theorem on global exponential stability of DDANN is shown by using this inequality. As an application of DDANN, a very concise criterion on global exponential stability for a neutral-type neural network is given by using DDANNs. Finally, two examples are given to illustrate the theoretical results.

PMID:33915455 | DOI:10.1016/j.neunet.2021.01.017

Oral Dis. 2021 Apr 29. doi: 10.1111/odi.13892. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the accuracy of MeMoSA^® , a mobile phone application to review images of oral lesions in identifying oral cancers and oral potentially malignant disorders requiring referral.

SUBJECTS AND METHODS: A prospective study of 355 participants, including 280 with oral lesions/variants was conducted. Adults aged ≥18 treated at tertiary referral centres were included. Images of the oral cavity were taken using MeMoSA^® . The identification of the presence of lesion/variant and referral decision made using MeMoSA^® were compared to clinical oral examination, using Kappa statistics for intra-rater agreement. Sensitivity, specificity, concordance and F1 score were computed. Images were reviewed by an off-site specialist and inter-rater agreement was evaluated. Images from sequential clinical visits were compared to evaluate observable changes in the lesions.

RESULTS: Kappa values comparing MeMoSA^® with clinical oral examination in detecting a lesion and referral decision was 0.604 and 0.892 respectively. Sensitivity and specificity for referral decision was 94.0% and 95.5%. Concordance and F1 score were 94.9% and 93.3% respectively. Inter-rater agreement for a referral decision was 0.825. Progression or regression of lesions were systematically documented using MeMoSA^® .

CONCLUSION: Referral decisions made through MeMoSA^® is highly comparable to clinical examination demonstrating it is a reliable telemedicine tool to facilitate the identification of high-risk lesions for early management.

PMID:33914993 | DOI:10.1111/odi.13892

Acta Physiol (Oxf). 2021 Apr 29:e13670. doi: 10.1111/apha.13670. Online ahead of print.

ABSTRACT

Physiological outputs are characterised by constant fluctuations, even under resting conditions.¹ Quantifying this variability represents an important methodological challenge. Variability in physiological outputs has traditionally been quantified according to its magnitude, using measures such as the standard deviation (SD).² Such magnitude-based measures have provided substantial insight into the analysis of physiological outputs, with changes in the magnitude of variability associated with adverse events in a number of systems.² However, physiological outputs are characterised by irregular self-similar fluctuations (“complexity”) over multiple orders of temporal magnitude (i.e. seconds, minutes, hours), a property magnitude-based measures cannot quantify.¹ Complexity measures derive from non-linear dynamics, and include metrics related to information theory (e.g. entropy statistics), which measure the apparent regularity or randomness of an output, and metrics drawn from fractal geometry, which identify long-range correlations present in an output.³ It has been suggested that neither magnitude- nor complexity-based metrics should be used as the sole indicator of system characteristics; rather, they should be used in conjunction, in order to provide a more complete understanding of variability.^2,4.

PMID:33915024 | DOI:10.1111/apha.13670

Dent Med Probl. 2021 Apr 29. doi: 10.17219/dmp/127963. Online ahead of print.

ABSTRACT

BACKGROUND: Telescopic implant-retained overdentures are considered one of the most common treatment modalities for edentulous patients.

OBJECTIVES: The aim of the study was to evaluate the retention of a BioHPP (biocompatible highperformance polymer) telescopic overdenture supported by customized abutments made from 2 different materials after the simulation of 1 year in function.

MATERIAL AND METHODS: Twelve models of a completely edentulous mandible were three-dimensionally (3D)-printed. Two implants and 2 groups of customized abutments – group Bio: BioHPP (n = 6) and group Ti: titanium (n = 6) – were used to support BioHPP telescopic overdentures. A vertically dislodging force was applied to each denture until its separation before and after 240,000 cycles of chewing simulation and 1,440 iterations of cyclic dislodgement for the simulation of 1 year in function in order to measure maximum tensile loads needed to dislodge the overdenture. Student’s t test and the paired t test were used for the statistical analysis (α = 0.05).

RESULTS: The initial and final retentive forces of the Ti group were significantly higher than in the case of the Bio group. A significant decrease in the retentive forces within the 2 groups after chewing simulation was observed and it was higher in group Ti; however, there was no statistically significant difference between the 2 groups.

CONCLUSIONS: The retentive force values for implant-retained telescopic overdentures significantly decreased after the simulation of 1 year of overdenture use. Both BioHPP and titanium are considered suitable abutment materials to retain telescopic overdentures.

PMID:33915039 | DOI:10.17219/dmp/127963

J Eur Acad Dermatol Venereol. 2021 Apr 29. doi: 10.1111/jdv.17318. Online ahead of print.

ABSTRACT

While there is clear evidence of an association between psoriasis and type 2 diabetes mellitus¹ , limited information is available on the prevalence of psoriasis in children and adolescents with type 1 diabetes mellitus (T1D).².

PMID:33914987 | DOI:10.1111/jdv.17318

Oncologist. 2021 Apr 29. doi: 10.1002/onco.13806. Online ahead of print.

ABSTRACT

BACKGROUND: Abemaciclib is a CDK4/6 inhibitor used to treat hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+, HER2-) advanced breast cancer (ABC). The prognostic value of patient-reported outcomes (PROs) have been minimally explored for treatment outcomes with CDK4/6 inhibitors. The performance of PROs compared to Eastern Cooperative Oncology Group Performance Status (ECOG-PS) is unknown.

MATERIAL AND METHODS: This study pooled data from single-arm trial, MONARCH 1, and randomized-trials, MONARCH 2 and 3. In total, 900 patients initiated abemaciclib and 384 comparator therapy. Pre-treatment PRO association with progression-free survival (PFS) was modelled using Cox proportional hazards regression. Prediction performance assessed via the C-statistic (c). PROs were recorded via the EORTC QLQ-C30.

RESULTS: Patient-reported physical function, pain, role function, fatigue and appetite loss were associated with PFS on univariable and adjusted analysis (P<0.05). Physical function (c=0.55) was most predictive, superior to ECOG-PS (c=0.54), with multivariable analysis indicating both provide independent information (P<0.02). In the pooled randomised arms of MONARCH 2 and 3, the PFS treatment benefit [HR (95% CI)] of abemaciclib (vs comparators) was 0.75 (0.57-1.0) for low physical function, compared to 0.48 (0.40-0.59) for intermediate/high (P[interaction] = 0.01).

CONCLUSION: PROs were identified as prognostic factors for PFS in patients initiating abemaciclib, with patient-reported physical function containing independent predictive information beyond ECOG-PS. Low physical function was associated with a decrease in the magnitude of PFS benefit from abemaciclib. PROs should be explored as prognostic, predictive and stratification factors for clinical use and research trials of CDK4/6 inhibitors.

IMPLICATIONS FOR PRACTICE: For the first time, pre-treatment patient-reported outcomes have been shown to be independent prognostic markers for progression-free survival (PFS) in patients diagnosed with HR+/HER2- advanced breast cancer treated with abemaciclib. Importantly, patients with low physical function had a smaller PFS benefit from abemaciclib (vs comparator) than patients with intermediate/high physical function. The present study demonstrates PROs as a simple, effective, inexpensive and independent prognostic marker for HR+/HER2- ABC patients treated with abemaciclib.

PMID:33914991 | DOI:10.1002/onco.13806

Int J Clin Pract. 2021 Apr 29:e14276. doi: 10.1111/ijcp.14276. Online ahead of print.

ABSTRACT

OBJECTIVES: Helicobacter pylori is a major cause of gastritis and a potential trigger of inflammatory disease. The effect of Helicobacter pylori infection on distal femoral cartilage has yet to be evaluated. The aim of this study was to evaluate femoral cartilage thickness in patients with helicobacter pylori infection and whether Helicobacter pylori infection affects femoral cartilage thickness.

METHODS: This cross-sectional study included 199 patients. To measure the thickness of femoral articular cartilage, 99 patients with Helicobacter pylori infections and 100 Helicobacter pylori negative controls were enrolled into two groups. The measurements were made using a linear probe ultrasonography with the patients in supine positions and their knees in maximum flexion. Demographic, clinical, endoscopic, and laboratory data were collected for all patients.

RESULTS: Both the right and left medial femoral condyles had thinner cartilage thickness in the Helicobacter pylori positive group than in the Helicobacter pylori negative group (p=0.016, p=0.036). For the intercondylar area and lateral femoral condyles, although the Helicobacter pylori positive patients had thinner femoral cartilage thickness than the Helicobacter pylori negative individuals for both extremities, this finding was not statistically significant (p>0.05).

CONCLUSION: Femoral cartilage was thinner in patients with Helicobacter pylori than patients without Helicobacter pylori for right and left medial femoral condyles. This study suggests that Helicobacter pylori infections may affect femoral cartilage thickness and potentially increase the risk of cartilage degeneration.

PMID:33914992 | DOI:10.1111/ijcp.14276

Int J Clin Pract. 2021 Apr 29:e14278. doi: 10.1111/ijcp.14278. Online ahead of print.

ABSTRACT

AIM: In this study, we aimed to evaluate the anxiety and depression status of prostate cancer (PCa) patients whose planned operations in the urology clinic of our hospital, which is serving as a pandemic hospital in Turkey have been postponed due to the coronavirus disease 2019 pandemic.

METHODS: This survey study was conducted at urology clinic of Ankara City Hospital between March 1 and June 1, 2020 and included 24 male patients who agreed to answer the questionnaires (State-Trait Anxiety Inventory [STAI] I and II and Beck Depression Inventory [BDI]). Demographical and clinical data (age, time since diagnosis, total serum prostate specific antigen (PSA) levels, risk groups according to the D’Amico classification system, smoking, alcohol habitus, major surgical history, and comorbidities) of the patients were collected from hospital software.

RESULTS: The mean STAI-I score of the patients (46.7 ± 1.4 [44-49]) was significantly higher than their STAI-II score (41.7 ± 2.4 [39-47]) (p < 0.001). The negative correlation between the decrease in age and STAI-I score was found to be statistically significant (r = 0.439, p < 0.05). The mean BDI score of the patients was 4.3 ± 3.2 (0-13), which was compatible with mild depression. There was no statistically significant difference between the time elapsed from diagnosis, PSA levels, smoking and alcohol habitus, major surgical history and comorbidity status, and STAI-I, STAI-II, and BDI scores (p > 0.05).

CONCLUSION: Prostate cancer patients with postponed operations should be guided properly in order to manage their anxiety status especially young patients.

PMID:33914983 | DOI:10.1111/ijcp.14278

Glob Chang Biol. 2021 Apr 29. doi: 10.1111/gcb.15661. Online ahead of print.

ABSTRACT

While wetlands are the largest natural source of methane (CH₄ ) to the atmosphere, they represent a large source of uncertainty in the global CH₄ budget due to the complex biogeochemical controls on CH₄ dynamics. Here we present, to our knowledge, the first multi-site synthesis of how predictors of freshwater wetland CH₄ fluxes (FCH4) vary across wetland types at diel, multiday (synoptic), and seasonal time scales. We used several statistical approaches (correlation analysis, generalized additive modeling, mutual information, random forests) in a wavelet-based multiresolution framework to assess the importance of environmental predictors, nonlinearities and lags on FCH4 across 23 eddy covariance sites. Seasonally, soil and air temperature were dominant predictors of FCH4 at sites with smaller seasonal variation in water table depth (WTD). In contrast, WTD was the dominant predictor for wetlands with smaller variations in temperature (e.g., seasonal tropical/subtropical wetlands). Changes in seasonal FCH4 lagged fluctuations in WTD by ~17 ± 11 days, and lagged air and soil temperature by median values of 8 ± 16 and 5 ± 15 days, respectively. Temperature and WTD were also dominant predictors at the multiday scale. Atmospheric pressure (PA) was another important multiday scale predictor for peat dominated sites, with drops in PA coinciding with synchronous releases of CH₄ . At the diel scale, synchronous relationships with latent heat flux and vapor pressure deficit suggest that physical processes controlling evaporation and boundary layer mixing exert similar controls on CH₄ volatilization, and suggest the influence of pressurized ventilation in aerenchymatous vegetation. In addition, 1-4 hour lagged relationships with ecosystem photosynthesis indicate recent carbon substrates, such as root exudates, may also control FCH4. By addressing issues of scale, asynchrony, and nonlinearity, this work improves understanding of the predictors and timing of wetland FCH4 that can inform future studies and models, and help constrain wetland CH₄ emissions.

PMID:33914985 | DOI:10.1111/gcb.15661