Category: Statistics

Jpn J Radiol. 2023 Jan 6. doi: 10.1007/s11604-022-01385-9. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the diagnostic performance of the transfer learning approach for grading diagnosis of ACL injury on a new modified dual precision positioning of thin-slice oblique sagittal FS-PDWI (DPP-TSO-Sag-FS-PDWI) sequence. And compare the prediction performances between artificial intelligence (AI) and radiologists.

MATERIALS AND METHODS: Patients with both DPP-TSO-Sag-FS-PDWI sequence and arthroscopic results were included. We performed a transfer learning approach using the pre-trained EfficientNet-B0 model, including whole image and regions of interest (ROI) image inputs, and reset its parameters to achieve an automatic hierarchical diagnosis of ACL.

RESULTS: A total of 235 patients (145 men and 90 women, 37.91 ± 14.77 years) with 665 images were analyzed. The consistencies of AI and arthroscopy (Kappa value > 0.94), radiologists and arthroscopy (Kappa value > 0.83, p = 0.000) were almost perfect. No statistical difference exists between the whole image and radiologists in the diagnosis of normal ACL (p = 0.063) and grade 3 injury (p = 1.000), while the whole image was better than radiologists in grade 1 (p = 0.012) and grade 2 injury (p = 0.003).

CONCLUSION: The transfer learning approach exhibits its feasibility in the diagnosis of ACL injury based on the new modified MR DPP-TSO-Sag-FS-PDWI sequence, suggesting that it can help radiologists hierarchical diagnose ACL injuries, especially grade 2 injury.

PMID:36607553 | DOI:10.1007/s11604-022-01385-9

Intensive Care Med Exp. 2023 Jan 6;11(1):3. doi: 10.1186/s40635-022-00485-0.

ABSTRACT

BACKGROUND: In refractory out-of-hospital cardiac arrest, transportation to hospital with continuous chest compressions (CCC) from a chest compression device and ventilation with 100% oxygen through an advanced airway is common practice. Despite this, many patients are hypoxic and hypercapnic on arrival, possibly related to suboptimal ventilation due to the counterpressure caused by the CCC. We hypothesized that a compression/ventilation ratio of 30:2 would provide better ventilation and gas exchange compared to asynchronous CCC during prolonged experimental cardiopulmonary resuscitation (CPR).

METHODS: We randomized 30 anaesthetized domestic swine (weight approximately 50 kg) with electrically induced ventricular fibrillation to the CCC or 30:2 group and bag-valve ventilation with a fraction of inspired oxygen (FiO₂) of 100%. We started CPR after a 5-min no-flow period and continued until 40 min from the induction of ventricular fibrillation. Chest compressions were performed with a Stryker Medical LUCAS® 2 mechanical chest compression device. We collected arterial blood gas samples every 5 min during the CPR, measured ventilation distribution during the CPR using electrical impedance tomography (EIT) and analysed post-mortem computed tomography (CT) scans for differences in lung aeration status.

RESULTS: The median (interquartile range [IQR]) partial pressure of oxygen (PaO₂) at 30 min was 110 (52-117) mmHg for the 30:2 group and 70 (40-171) mmHg for the CCC group. The median (IQR) partial pressure of carbon dioxide (PaCO₂) at 30 min was 70 (45-85) mmHg for the 30:2 group and 68 (42-84) mmHg for the CCC group. No statistically significant differences between the groups in PaO₂ (p = 0.40), PaCO₂ (p = 0.79), lactate (p = 0.37), mean arterial pressure (MAP) (p = 0.47) or EtCO₂ (p = 0.19) analysed with a linear mixed model were found. We found a deteriorating trend in PaO₂, EtCO₂ and MAP and rising PaCO₂ and lactate levels through the intervention. There were no differences between the groups in the distribution of ventilation in the EIT data or the post-mortem CT findings.

CONCLUSIONS: The 30:2 and CCC protocols resulted in similar gas exchange and lung pathology in an experimental prolonged mechanical CPR model.

PMID:36607514 | DOI:10.1186/s40635-022-00485-0

Med Biol Eng Comput. 2023 Jan 6. doi: 10.1007/s11517-022-02764-0. Online ahead of print.

ABSTRACT

The multichannel objective response detection (MORD) techniques are statistical methods, which use information from more than one electroencephalography (EEG) channel, to infer the presence of evoked potential. However, the correlation level between the channels can lead to a decrease in MORD performance, such as an increase in the false positive (FP) rate and/or a decrease in the detection rate (DR). The present study aims to propose a method to deal with the correlations in the multichannel EEG. The method consists of making an adjustment in the Monte Carlo simulation, considering the information between channels. The MORD techniques with and without the new method were applied to an auditory steady-state response (ASSR) database, composed of the EEG multichannel of eleven volunteers during multifrequency stimulation. The proposed method kept the FP rate at values equal to or less than the significance level of the test and led to an increase of 8.51% in the DR in relation to non-application of the method. Results of this study indicate that the proposed method is an alternative to deal with the effect of the correlation between channels in situations where MORD techniques are applied.

PMID:36607504 | DOI:10.1007/s11517-022-02764-0

Clin Oral Investig. 2023 Jan 6. doi: 10.1007/s00784-022-04845-8. Online ahead of print.

ABSTRACT

OBJECTIVE: This study was aimed to delineate the clinical, CBCT radiographic characteristics, and complications of maxillary molar in a periodontitis population.

MATERIALS AND METHODS: Medical records and CBCT images were utilized to identify adult patients with periodontitis in a tertiary referral dental hospital between June 2019 and December 2020. CBCT scan images were used to characterize the detailed bone thickness, absorbing height, and position of maxillary molar as well as their associated conditions. All relevant descriptive epidemiological data, clinical information, radiographic details, and associated complications were recorded and statistically analyzed.

RESULTS: According to the above criteria, 577 eligible periodontitis patients were enrolled and defined as research cohort here with mean age 45 ± 4.8 years. Male patients outnumbered females with a gender ratio of 1.23:1. Our results demonstrated that the bone loss of maxillary first molar was more serious than that of second molar with tooth position symmetry. The occurrence of various complications (periodontal abscess, pulp lesions, furcation lesion, and mucosal thickening) was significantly correlated to periodontal-related clinical parameters of maxillary molar.

CONCLUSIONS: Our results demonstrated the more serious bone loss of maxillary first molar with tooth position symmetry. The occurrence of various complications was significantly correlated to periodontal-related clinical parameters. Our findings offer valuable information concerning the clinical, radiographic characteristics, and complications of maxillary molar in a periodontitis population.

CLINICAL RELEVANCE: These findings are beneficial for clinicians to comprehensively understand the bone status, pathogenesis, and clinical management of maxillary molar in periodontitis.

PMID:36607492 | DOI:10.1007/s00784-022-04845-8

Clin Oral Investig. 2023 Jan 6. doi: 10.1007/s00784-022-04785-3. Online ahead of print.

ABSTRACT

OBJECTIVES: The development of new bleaching agents with minimum concentration of hydrogen peroxide (HP), without adverse effects, and with bleaching effectiveness, has great clinical relevance. The aim of this study was to evaluate the bleaching efficacy and cytotoxicity of a new niobium-based bleaching gel, compared to already available HP-based gels.

MATERIALS AND METHODS: For the bleaching efficacy analysis, 40 bovine incisors were randomly divided into 4 groups according to the established bleaching protocol: control, untreated; 35HP, 35% HP bleaching gel; 6HP, 6% HP bleaching gel; NbHP, niobium gel associated with 3% HP gel. The color variation was measured in a spectrophotometer and the values of ΔL, Δa, Δb, and ΔE obtained. For the cell viability assay by MTT, MC3T3 cells were exposed to bleaching gel extracts (1:500, 1:250, 1:125 dilutions; immediately and 24 h). Statistical tests were performed (P < 0.05).

RESULTS: The color alteration for all bleaching gels was significant compared to control (P < 0.05), but the NbHP gel showed a significant ΔE than other gels, with expressive color alteration at 14 days (P < 0.05). The 35HP showed high cytotoxicity regarding control and the most groups in all periods and extracts analyzed (P < 0.05), while the NbHP showed greater cell viability than control in the immediate period, dilution of the 1:500 and superior to 6HP in the most extracts at 24 h.

CONCLUSION: The new experimental niobium-based gel has bleaching efficacy similar to that of gels with a high concentration of HP, and it has high cytocompatibility.

CLINICAL RELEVANCE: The use of this new generation of niobium-based whitening gel associated with a low concentration of hydrogen peroxide represents the possibility of a tooth whitening with lower dentin sensitivity.

PMID:36607491 | DOI:10.1007/s00784-022-04785-3

Int J Clin Oncol. 2023 Jan 6. doi: 10.1007/s10147-022-02285-8. Online ahead of print.

ABSTRACT

PURPOSE: Here, we investigated expression modules reflecting the reciprocal expression of the cancer microenvironment and immune response-related genes associated with poor prognosis in primary central nervous system lymphoma (PCNSL).

METHODS: Weighted gene coexpression network analysis revealed representative modules, including neurogenesis, immune response, anti-virus, microenvironment, gene expression and translation, extracellular matrix, morphogenesis, and cell adhesion in the transcriptome data of 31 PCNSL samples. RESULTS : Gene expression networks were also reflected by protein-protein interaction networks. In particular, some of the hub genes were highly expressed in patients with PCNSL with prognoses as follows: AQP4, SLC1A3, GFAP, CXCL9, CXCL10, GBP2, IFI6, OAS2, IFIT3, DCN, LRP1, and LUM with good prognosis; and STAT1, IFITM3, GZMB, ISG15, LY6E, TGFB1, PLAUR, MMP4, FTH1, PLAU, CSF3R, FGR, POSTN, CCR7, TAS1R3, small ribosomal subunit genes, and collagen type 1/3/4/6 genes with poor prognosis. Furthermore, prognosis prediction formulae were constructed using the Cox proportional-hazards regression model, which demonstrated that the IP-10 receptor gene CXCR3 and type I interferon-induced protein gene IFI44L could predict patient survival in PCNSL.

CONCLUSION: These results indicate that the differential expression and balance of immune response and microenvironment genes may be required for PCNSL tumor growth or prognosis prediction, which would help understanding the mechanism of tumorigenesis and potential therapeutic targets in PCNSL.

PMID:36607476 | DOI:10.1007/s10147-022-02285-8

Neurosurg Rev. 2023 Jan 6;46(1):33. doi: 10.1007/s10143-022-01932-y.

ABSTRACT

Giant lateral ventricular meningiomas (LVMs), with the largest diameter of at least 5 cm, form a distinct subset. The incidence of giant LVMs is considered to be relatively low. Here, we evaluated clinical characteristics, and clinical outcomes after microsurgical resection, especially functional outcomes and morbidity of giant LVMs. We retrospectively reviewed 49 patients with LVMs, including 18 giant LVMs from 2012 to 2020. And we analyzed clinical, histopathological, surgical, and outcome data at our institution. Giant LVMs were most commonly present in the fourth decade of patients with the male-to-female ratio of 1:2. The most common subtypes were transitional and fibrous. Most lesions were resected via the temporal or parieto-occipital approach in our series. The median volume of blood loss was higher in the giant group (900 vs. 600 ml, p = 0.02). Meanwhile, the median length of hospital stay was prolonged for giant LVMs (20.5 vs. 16.0 days, p < 0.01). The proportion of discharged functional deterioration was higher in giant LVMs (38.9% vs. 6.5%, p = 0.02). However, there was no statistical significance between functional deterioration and tumor size at long-term follow-up (p = 0.28). Giant LVMs patients suffered from neurological and regional complications more commonly, particularly from a postoperative hematoma (4/18 vs. 1/31), and hydrocephalus (2/18 vs. 0/31). Patients with giant LVMs had a high incidence of immediate functional deterioration after microsurgery, and there was no difference in functional deterioration between the giant and non-giant LVMS during long-term follow-up. Microsurgery entails a higher complication rate in giant LVMs. We need to pay special attention to preventing postoperative hematoma and hydrocephalus.

PMID:36607461 | DOI:10.1007/s10143-022-01932-y

Hernia. 2023 Jan 6. doi: 10.1007/s10029-022-02733-4. Online ahead of print.

ABSTRACT

BACKGROUND: Patient-Reported Outcome Measures (PROM’s) are increasingly used to assess surgical outcomes in low-risk surgeries such as minimally invasive primary ventral and incisional hernia repair. The purpose of this meta-analysis was to systematically summarize the available evidence for the effect of laparoscopic versus robotic primary ventral and incisional hernia repair on PROM’s.

METHODS: A systematic review and meta-analysis were performed in accordance with PRISMA guidelines. Randomised control trials, retrospective and prospective studies were included. Medline, Embase, SCOPUS, Web of Science, and Cochrane CENTRAL, and two trial registers were searched. Pooled effect sizes and 95% confidence intervals were calculated using the Mantel-Haenszel method. The overall quality of evidence was assessed using GRADE.

RESULTS: Of the 2728 titles screened, eight studies involving 41,205 participants were included. Return to activities of daily living, return to work day and recurrence rate were statistically better in the robotic group. Length of stay, readmission, postoperative pain, quality of life, body image, and patient satisfaction were similar in both groups. The GRADE rating of the quality of evidence was moderate for postoperative pain and low to very low for the quality of life, length of stay, recurrence and readmission.

CONCLUSION: The available data of PROM’s of laparoscopic and robotic primary ventral and incisional hernia repair is scarce and highly heterogeneous, thus making it difficult to assess the superiority of the laparoscopic technique over the robotic technique. Further studies with uniform reporting of PROM’s in laparoscopic and robotic primary ventral and incisional hernia repair are needed.

PMID:36607459 | DOI:10.1007/s10029-022-02733-4

Environ Monit Assess. 2023 Jan 6;195(2):271. doi: 10.1007/s10661-022-10879-y.

ABSTRACT

Concerning water resources, several ordinances and legislation determine standards and conditions for the discharge of effluents into water bodies. However, several contaminants are not covered by these guidelines due to little knowledge of their long-term effects and because they are found in low concentrations. These contaminants are called emergent and this category includes drugs, such as anti-inflammatory drugs. The electrocoagulation process associated with advanced oxidation comes up as an alternative to conventional effluent treatment processes, and the objective of this study was to evaluate this process using scrap iron as sacrificial electrodes in the treatment of synthetic effluents containing ibuprofen. High-performance liquid chromatography was used to quantify the drug in synthetic effluents. The Central Rotational Composite Design 2⁴ was used in an experimental design, considering independent variables the concentration of contaminants, applied current, the concentration of the primary oxidizing agent H₂O₂, and the reaction time. The optimized conditions determined by statistical analysis were drug concentration of 5 mg L^-1, H₂O₂ concentration of 200 mg L^-1, current of 5 A, and 150 min. The removals obtained under these conditions were higher than 92% in the aqueous phase, showing that electrocoagulation peroxidation technique has the potential to treat contaminants such as drugs present in effluents and waters.

PMID:36607457 | DOI:10.1007/s10661-022-10879-y

World J Microbiol Biotechnol. 2023 Jan 6;39(3):68. doi: 10.1007/s11274-022-03503-1.

ABSTRACT

The production of poly(3-hydroxybutyrate) [P(3HB)] from untreated raw palm oil mill effluent (urPOME), the first wastewater discharge from crude palm oil extraction, is discussed. The mutant strain Azotobacter vinelandii ΔAvin_16040, which lacks the S-layer protein but has a better P(3HB) synthesis capability than the wild type strain ATCC 12,837, was chosen for this study. UrPOME substrate, with high biological oxygen demand (BOD), chemical oxygen demand (COD) and suspended solids, was used without pre-treatment. DSMZ-Azotobacter medium which was devoid of laboratory sugar(s) was used as the basal medium (BaM). Initially, Azotobacter vinelandii ΔAvin_16040 generated 325.5, 1496.3, and 1465.7 mg L^-1 of P(3HB) from BaM with 20% urPOME, 2BaM with 20% urPOME and 20 g L^-1 sucrose, and 2BaM with 20% urPOME and 2 mL L^-1 glycerol, respectively. P(3HB) generation was enhanced by nearly tenfold using statistical optimization, resulting in 13.9 g L^-1. Moreover, the optimization reduced the compositions of mineral salts and sugar in the medium by 48 and 97%, respectively. The urPOME-based P(3HB) product developed a yellow coloration most possibly attributed to the aromatic phenolics content in urPOME. Despite the fact that both were synthesised by ΔAvin_16040, thin films of urPOME-based P(3HB) had superior crystallinity and tensile strength than P(3HB) produced only on sucrose. When treated with 10 and 50 kGy of electron beam irradiation, these P(3HB) scissioned to half and one-tenth of their original molecular weights, respectively, and these cleavaged products could serve as useful base units for specific polymer structure construction.

PMID:36607449 | DOI:10.1007/s11274-022-03503-1