Category: Statistics

J Neural Eng. 2021 Apr 13. doi: 10.1088/1741-2552/abf772. Online ahead of print.

ABSTRACT

OBJECTIVE: To explore the viability of developing a computer-aided diagnostic system for Parkinsonian syndromes using dynamic [11C]raclopride PET and T1-weighted MRI data.

APPROACH: The biological heterogeneity of Parkinsonian syndromes renders their statistical classification a challenge. The unique combination of structural and molecular imaging data allowed different classifier designs to be tested. Datasets from dynamic [11C]raclopride PET and T1-weighted MRI scans were acquired from six groups of participants: healthy controls (CTRL n=15), patients with Parkinson’s disease (PD n=27), multiple system atrophy (MSA n=8), corticobasal degeneration (CBD n=6), and dementia with Lewy bodies (DLB n=5). MSA, CBD, and DLB patients were classified into one category designated as atypical parkinsonism (AP). The distribution volume ratio (DVR) kinetic parameters obtained from PET data were used to quantify the reversible tracer binding to D2/D3 receptors in the subcortical regions of interest (ROI). Grey matter (GM) volumes obtained from the MRI data were used to quantify GM atrophy across cortical, subcortical, and cerebellar ROI.

RESULTS: The classifiers CTRL vs PD and CTRL vs AP achieved the highest balanced accuracy combining DVR and GM (DVR-GM) features (96.7%, 92.1%, respectively), followed by the classifiers designed with DVR features (93.3%, 88.8%, respectively), and GM features (69.6%, 86.1%, respectively). In contrast, the classifier PD vs AP showed the highest balanced accuracy (78.9%) using DVR features only. The integration of DVR-GM (77.9%) and GM features (72.7%) produced inferior performances. The classifier CTRL vs PD vs AP showed high weighted balanced accuracy when DVR (80.5%) or DVR-GM features (79.9%) were integrated. GM features revealed poorer performance (59.5%).

SIGNIFICANCE: This work was unique in its combination of structural and molecular imaging features in binary and triple category classifications. We were able to demonstrate improved binary classification of healthy/diseased status (concerning both PD and AP) and equate performance to DVR features in multiclass classifications.

PMID:33848996 | DOI:10.1088/1741-2552/abf772

Acta Haematol. 2021 Apr 13:1-9. doi: 10.1159/000514907. Online ahead of print.

ABSTRACT

OBJECTIVE: The objective of this study was to determine the expression of G protein-coupled receptors (GPCRs) in platelets from adult patients with chronic immune thrombocytopenic purpura (ITP).

METHODS: Peripheral blood samples were collected from 40 patients with chronic ITP in the Second Affiliated Hospital of Shantou University Medical College, and 40 peripheral blood samples from healthy volunteers were collected; expressions of the adenosine diphosphate receptors (P2Y1 and P2Y12), alpha-2A adrenergic receptor (α2A-AR), and thromboxane A2 receptor (TP) in platelets were detected by flow cytometry. Gα protein, protease-activated receptor 1 (PAR1), and protease-activated receptor 4 (PAR4) were analyzed by Western blot and analyzed statistically.

RESULTS: Flow cytometry measurements of mean fluorescence intensities showed platelets from patients with chronic ITP, compared to healthy individuals, had significantly higher levels of P2Y1 (31.4 ± 2.2 vs. 7.8 ± 0.8), P2Y12 (29.6 ± 2.1 vs. 7.2 ± 1.3), α2A-AR (25.8 ± 2.9 vs. 9.8 ± 0.9), and TP (39.8 ± 3.1 vs. 4.7 ± 0.6) (all p < 0.01). Similarly, integrated optical density analysis of Western blots showed that platelets from patients with chronic ITP had significantly higher levels of Gα (1046.3 ± 159.96 vs. 254.49 ± 39.51), PAR1 (832.98 ± 98.81 vs. 203.92 ± 27.47), and PAR4 (1518.80 ± 272.45 vs. 431.27 ± 41.86) (all p < 0.01).

CONCLUSION: Expression of GPCRs is increased in platelets from patients with chronic ITP, suggesting that platelets of chronic ITP may participate in the complicated biological process by means of GPCR-mediated signaling pathways.

PMID:33849009 | DOI:10.1159/000514907

J Biomech. 2021 Apr 5;121:110417. doi: 10.1016/j.jbiomech.2021.110417. Online ahead of print.

ABSTRACT

A frog can jump several times higher than its own height and then land smoothly on the ground. During the buffering phase, both forelimbs touch the ground and compact quickly to absorb most of the impact energy. However, the adjustment of the joint angles of the forelimb and the induced cushioning effect during the landing process have not been thoroughly investigated. In this study, we statistically summarized the angular displacements of forelimb joints with respect to landing velocities by using a high-speed motion capture system. It is found many joint angles were linearly influenced by landing velocity at both ground touching moment and maximum compression moment. Moreover, the double-peak pattern of ground reactive force was measured, which attributes to the forelimb landing and the followed abdomen/hindlimb landing. Before the appearance of the first peak, the compression of the forelimb and the reactive force revealed a linear relationship regardless of velocity, implying that the forelimbs act as a constant stiffness spring in landing. Accordingly, a simple spring-mass model was proposed and verified by simulation for forelimb cushioning of the frog. We anticipate our achievements to inspire the design of future landing mechanisms.

PMID:33848828 | DOI:10.1016/j.jbiomech.2021.110417

J Surg Res. 2021 Apr 10;264:462-468. doi: 10.1016/j.jss.2021.02.044. Online ahead of print.

ABSTRACT

BACKGROUND: Using the platform of morbidity and mortality conference, we developed and executed a combined faculty-resident intervention called “Education M&M” to discuss challenges faced by both parties in the operating room (OR), identify realistic solutions, and implement action plans. This study aimed to investigate the impact of this intervention on resident OR training.

MATERIALS AND METHODS: Two resident case presentations were followed by audience discussion and recommendations regarding actionable solutions aimed at improving resident OR training from an expert faculty panel. Postintervention surveys were completed by participants immediately and 2 mo later to assess perceived short and long-term impact on OR teaching and/or learning and the execution of two recommended solutions. Descriptive statistical analysis was applied.

RESULTS: Immediate post-intervention surveys (n = 44) indicated that 81.8% of participants enjoyed the M&M “a lot”; 90.1% said they would use some or a lot of the ideas presented. Awareness of OR teaching/learning challenges before and after the M&M improved from 3.0 to 3.7 (P = 0.00001) for faculty and 3.0 to 3.9 for trainees (P = 0.00004). Understanding of OR teaching and/or learning approaches improved from 3.1 to 3.7 for faculty (P = 0.00004) and 2.7 to 3.9 for trainees (P = 0.00001). In 2-mo post-intervention surveys, most residents had experienced two recommended solutions (71% and 88%) in the OR, but self-reported changes to faculty behavior did not reach statistical significance.

CONCLUSIONS: A department-wide education M&M could be an effective approach to enhance mutual communication between faculty members and residents around OR teaching/learning by identifying program-specific challenges and potential actionable solutions.

PMID:33848846 | DOI:10.1016/j.jss.2021.02.044

Epilepsy Behav. 2021 Apr 10;118:107946. doi: 10.1016/j.yebeh.2021.107946. Online ahead of print.

ABSTRACT

OBJECTIVE: This study was aimed to analyze the effectiveness of sodium channel blockers (SCBs) in CDKL5 deficiency disorder (CDD)-related epilepsy.

METHODS: A retrospective, observational study was performed, including patients with CDD diagnosis evaluated between 2016 and 2019 at three tertiary Epilepsy Centers. Demographic, electroclinical and genetic features, as well as ASM treatments and their outcomes were analyzed, with special focus on SCBs.

RESULTS: Twenty-one patients evaluated at three tertiary Epilepsy Centers were included, of which 19 presented with epilepsy (90.5%); all had pathogenic mutations of CDKL5. Six patients (31.6%) were classified as SCB responders (more than 50% reduction), four being currently seizure free (mean seizure-free period of 8 years). Most frequent SCB drugs were oxcarbazepine (OXC), carbamazepine (CBZ), and lacosamide (LCM). None of them presented relevant adverse events. In contrast, three patients showed seizure aggravation in the non-responder group. When comparing both groups, responders had statistically significant younger age at SCB treatment and epilepsy onset, higher proportion of focal epileptiform activity and less frequent history of West syndrome.

CONCLUSIONS: The results of this study indicate that treatment with SCBs might be effective and safe in a subset of patients with CDD-related epilepsy.

PMID:33848848 | DOI:10.1016/j.yebeh.2021.107946

Leg Med (Tokyo). 2021 Apr 7;51:101877. doi: 10.1016/j.legalmed.2021.101877. Online ahead of print.

ABSTRACT

Heroin-related mortality is a complex phenomenon involving several factors that make an individual more susceptible to opioid toxicity. Among these, pre-existing pathological conditions play an important role. The current paper reviewed 51 autopsied cases performed over the last 30 years, each subject (“frequent heroin user”) having taken heroin intravenously alone before death. For each case, total blood morphine concentration determined by gas chromatography-mass spectrometry (GC-MS) was obtained from the archives. For histopathological evaluation we examined microscopic sections of the heart, lung, brain, liver and kidney, and for each organ a score table with a numerical value from 1 to 5, as an indicator of increasing severity, was drawn up. Finally, we created a scoring system based on the Injury Severity Score (ISS), generated by the sum of the squares of the three highest organ scores. We investigated the relationship between total blood morphine value (mg/l) and pathological score by inserting the two variables in a linear regression model: Score = a + b·Morphinemia (p-value <0.001). The results demonstrated a statistically significant correlation between the two variables: individuals with low total blood morphine values tended to have a higher pathological score. Our study provides useful assessment tools for forensic practice, confirming the need to combine two important disciplines in drug death investigation: forensic pathology and toxicology.

PMID:33848788 | DOI:10.1016/j.legalmed.2021.101877

Seizure. 2021 Apr 6;88:125-129. doi: 10.1016/j.seizure.2021.04.005. Online ahead of print.

ABSTRACT

Purpose To quantify the influence of prior knowledge about the patient and the EEG circumstances on the EEG-based seizure detection rate. Methods A sample of 95 EEGs with epileptic seizure patterns matched with 95 seizure-free control sequences were extracted from EEG video monitoring data. They were stripped of all additional information. These plain EEG recordings were evaluated by two board certified EEG reviewers. The results were compared with the interpretations of the original video monitoring evaluations. Results Using the plain EEG sequences, epileptic seizure patterns were detected with a sensitivity and specificity of 0.758 and 0.958, respectively. The classification of the seizure pattern localization and lateralization differed in 56% and 50%, respectively, from the results of the video monitoring evaluations. Conclusion Additional information about the patient and the events during an EEG recording leads to a clinically and statistically significant increase in the seizure detection rates. These results imply that the human evaluation of a plain EEG without further information may not be seen as the gold standard in EEG evaluation. The performance estimation of automated EEG evaluation methods should take this into account.

PMID:33848791 | DOI:10.1016/j.seizure.2021.04.005

Nutrition. 2021 Mar 4;89:111228. doi: 10.1016/j.nut.2021.111228. Online ahead of print.

ABSTRACT

OBJECTIVES: The aim of this study was to understand the diet-related behaviors of Hainan centenarians and to analyze dietary factors that affect their nutritional status.

METHODS: Data were collected from the China Hainan Centenarian Cohort Study, a full sample survey including questionnaires, physical examinations, and physiologic indices of the centenarian population. The study included 1002 centenarians. The diet-related behaviors were assessed using the food frequency questionnaire; nutritional status was determined according to the Mini Nutritional Assessment – short form scale scores. We used logistic regression models to analyze the main dietary risk factors of malnutrition.

RESULTS: Of all the centenarians, 94.6% maintained regular meals, 80.4% had three meals a day, 53.4% ate each meal until 80% full, 88.7% ate vegetables daily, and 70% drank one to two cups of water daily. Centenarians ate rice-based staple foods; eggs, dairy, legumes, nuts, and poultry were not popular. The main sources of meat were red meat and seafood. None liked fried food, and 19.3% preferred sweet flavors. People with normal nutritional status accounted for 12.3% of the population, whereas those with malnutrition comprised 20.8%. Dietary factors that affected nutritional status included three meals a day (odds ratio [OR], 0.366; 95% confidence interval [CI], 0.173-0.778), tea drinking (OR, 0.236; 95% CI, 0.087-0.641), and the frequency of poultry (OR, 0.261; 95% CI, 0.088-0.771), seafood (OR, 0.247; 95% CI, 0.110-0.554), nuts (OR, 0.381; 95% CI, 0.150-0.965), and pastry (OR, 0.219; 95% CI, 0.080-0.600) consumption.

CONCLUSION: This was the first study on the dietary behaviors and nutritional status of centenarians using survey data. We highlighted the factors affecting nutritional status and provided scientific support for dietary strategies that may improve the nutritional status of the elderly population.

PMID:33848822 | DOI:10.1016/j.nut.2021.111228

Surg Oncol. 2021 Apr 5;37:101565. doi: 10.1016/j.suronc.2021.101565. Online ahead of print.

ABSTRACT

BACKGROUND: We compared the curettage/bone grafting and the curettage/bone graft substitutes surgical techniques in their relation to functional outcomes, oncologic outcome (recurrence, malignant transformation), the rate of postsurgical complications, durations of surgery and of postsurgical immobilization for hand-localized cases of solitary and multiple enchondromas.

METHODS: The current prospective randomized trial analyzed 200 adult patients (2012-2017) with enchondroma who underwent surgical intervention. The cases were randomly divided into Group 1 (n = 100; F 56, M 44) for surgeries with curettage and autogenous bone grafting, and Group 2 (n = 100; F 55, M 45) for surgeries with curettage and bone graft substitutes. The placebo control Group 3 consisted of cases operated by curettage only (n = 56; F 31, M 25). The follow-up period was set at 30 months.

RESULTS: The duration of surgery was 51 ± 4 min in Group 1 and 27 ± 1 min in Group 2 (p = 0.008). In Group 1, the rate of recurrence was 6% against 1% in Group 2 (p = 0.005). No other statistically significant differences in postsurgical outcomes between three involved groups were noted.

CONCLUSION: In cases of enchondroma of the hand, postsurgical functional outcomes, the rate of postsurgical complications, the duration of immobilization, and the time to complete recovery are not influenced by the type of chosen grafting material. The implementation of HAp-collagen bone substitutes in granules instead of autogenous bone grafting reduces the duration of surgery. The implementation of autogenous bone grafting may increase the rate of tumor recurrence.

PMID:33848764 | DOI:10.1016/j.suronc.2021.101565

Soc Sci Med. 2021 Apr 3;277:113898. doi: 10.1016/j.socscimed.2021.113898. Online ahead of print.

ABSTRACT

CONTEXT: Prior research suggests the potential for political campaign advertisements to increase psychological distress among viewers. The current study tests relationships between estimated exposure to campaign advertising and the odds of respondents reporting that a doctor told them they have anxiety, depression, insomnia, or (as a negative control) cancer.

METHODS: A secondary analysis of U.S. data on televised campaign ad airings from January 2015 to November 2016 (n = 4,659,038 airings) and five waves of a mail survey on television viewing patterns and self-reported medical conditions from November 2015 to March 2017 (n = 28,199 respondents from n = 16,204 unique households in the U.S.).

FINDINGS: A 1 percent increase in the estimated volume of campaign advertising exposure was associated with a 0.06 [95% CI 0.03-0.09] percentage point increase in the odds of a respondent being told by a doctor that they have anxiety in the past 12 months. We observed this association regardless of the political party of the ad sponsor, the political party of the respondent, or their statistical interaction. We also observed this association for both Presidential campaign ads and non-Presidential (including local, state, and U.S. congressional election) campaign ads, providing evidence that these relationships were not driven by the unique divisiveness of the race between Donald Trump and Hilary Clinton. Some topic-specific models offered additional evidence of association between estimated volume of campaign advertising exposure and the odds of being told by a doctor that they have depression or insomnia, but these patterns were less consistent across models that utilized different categories of campaign exposure. Campaign ad exposure was not associated with cancer, which served as a negative control comparison.

CONCLUSIONS: There was a consistent positive association between the volume of campaign advertising exposure and a reported diagnosis of anxiety among American adults.

PMID:33848716 | DOI:10.1016/j.socscimed.2021.113898