Nevin Manimala

Clin Neurol Neurosurg. 2021 May 19;206:106697. doi: 10.1016/j.clineuro.2021.106697. Online ahead of print.

ABSTRACT

INTRODUCTION: The Charlson Comorbidity Index (CCI) score has been shown to predict 10-year all-cause mortality and post-neurosurgical complications but has never been examined in a far lateral disc herniation (FLDH) population. This study aims to correlate CCI score with adverse outcomes following FLDH repair.

PATIENTS AND METHODS: All patients (n = 144) undergoing discectomy for FLDH at a single, multihospital academic medical system (2013-2020) were retrospectively analyzed. CCI scores were determined for all patients. Univariate logistic regression was used to determine the ability of CCI score to predict adverse outcomes.

RESULTS: Mean age of the population was 61.72 ± 11.55 years, 69 (47.9%) were female, and 126 (87.5%) were non-Hispanic white. Patients underwent either open (n = 92) or endoscopic (n = 52) FLDH repair. Average CCI score among the patient population was 2.87 ± 2.42. Each additional point in CCI score was significantly associated with higher rates of readmission (p = 0.022, p = 0.014) in the 30-day and 30-90-day post-surgery window, respectively, and emergency department visits (p = 0.011) within 30-days. CCI score also predicted risk of reoperation of any kind (p = 0.013) within 30 days of the index operation. In addition, CCI score was predictive of risk of reoperation of any kind (p = 0.008, p < 0.001; respectively) and repeat neurosurgical intervention (p = 0.027, p = 0.027) within 30-days and 90-days of the index admission (either during the same admission or after discharge).

CONCLUSIONS: This study suggests that CCI score is a useful metric to predict of numerous adverse postoperative outcomes following discectomy for FLDH.

PMID:34030078 | DOI:10.1016/j.clineuro.2021.106697

Accid Anal Prev. 2021 May 21;157:106158. doi: 10.1016/j.aap.2021.106158. Online ahead of print.

ABSTRACT

Driving errors and violations are highly relevant to the safe systems approach as human errors tend to be a predominant cause of crash occurrence. In this study, we harness highly detailed pre-crash Naturalistic Driving Study (NDS) data 1) to understand errors and violations in crash, near-crash, and baseline (no event) driving situations, and 2) to explore pathways that lead to crashes in diverse built environments by applying rigorous modeling techniques. The “locality” factor in the NDS data provides information on various types of roadway and environmental surroundings that could influence traffic flow when a precipitating event is observed. Coded by the data reductionists, this variable is used to quantify the associations of diverse environments with crash outcomes both directly and indirectly through mediating driving errors and violations. While the most prevalent errors in crashes were recognition errors such as failing to recognize a situation (39 %) and decision errors such as not braking to avoid a hazard (34 %), performance errors such as poor lateral or longitudinal control or weak judgement (8 %) were most strongly correlated with crash occurrence. Path analysis uncovered direct and indirect relationships between key built-environment factors, errors and violations, and crash propensity. Possibly due to their complexity for drivers, urban environments are associated with higher chances of crashes (by 6.44 %). They can also induce more recognition errors which correlate with an even higher chances of crashes (by 2.16 % with the “total effect” amounting to 8.60 %). Similar statistically significant mediating contributions of recognition errors and decision errors near school zones, business or industrial areas, and moderate residential areas were also observed. From practical applications standpoint, multiple vehicle technologies (e.g., collision warning systems, cruise control, and lane tracking system) and built-environment (roadway) changes have the potential to reduce driving errors and violations which are discussed in the paper.

PMID:34030046 | DOI:10.1016/j.aap.2021.106158

Spectrochim Acta A Mol Biomol Spectrosc. 2021 May 11;260:119943. doi: 10.1016/j.saa.2021.119943. Online ahead of print.

ABSTRACT

A comparative study of successive spectrophotometric resolution technique for the simultaneous determination of a challengeable quaternary mixture of Chlorpheniramine maleate (CPM), Pseudoephedrine hydrochloride (PSE), Ibuprofen (IBU) and Caffeine (CAF) is presented, without preliminary physical separation steps. Several successive steps were applied on built-in spectrophotometer software utilizing zero and/or derivative and/or ratio spectra of the studied components. These methods, namely, Dual amplitude difference (DAD) as a novel method, Constant multiplication coupled with spectrum subtraction method (CM-SS), Factorized first derivative coupled with derivative transformation method (FD¹ -DT) and Derivative ratio method (DD¹). The calibration graphs are linear over the concentration range of 10.0-80.0 μg/mL,150.0-900.0 μg/mL, 200.0-1400.0 μg/mL and 3.0-30.0 μg/mL for CPM, PSE, IBU and CAF, respectively. The specificity of suggested methods was studied via laboratory prepared (diverse ratios) mixtures and were successfully applied for Antiflu® capsules’ analysis. Moreover, sample enrichment via In Silico (via software of spectrophotometer) and In Lab (via spiking with pure sample) techniques was elected for a pharmaceutical dosage form analysis comprising CPM and PSE as minor components. Accuracy, precision and specificity were between the valid limits. Validation steps were done in accordance with the ICH guidelines. Moreover, statistical comparison was carried out between the obtained and reported results for pure powder form and no significant difference appeared.

PMID:34030038 | DOI:10.1016/j.saa.2021.119943

Epilepsy Behav. 2021 May 21;121(Pt A):108003. doi: 10.1016/j.yebeh.2021.108003. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: We performed a systematic review to evaluate available risk models to predict late seizure onset among stroke survivors.

METHODS: We searched major databases (PubMed, SCOPUS, and Cochrane Library) from inception to October 2020 for articles on the development and/or validation of risk models to predict late seizures after a stroke. The impact of models to predict late-onset seizures was also assessed. We included seven articles in the final analysis. For each of these studies, we evaluated the study design and scope of predictors analyzed to derive each model. We assessed the performance of the models during internal and external validation in terms of discrimination and calibration.

RESULTS: Three studies focused on ischemic stroke alone, with c-statistic values ranging from 0.73 to 0.77. The SeLECT model from Switzerland was externally validated in Italian, German, and Austrian cohorts where c-statistics ranged from 0.69 to 0.81. This model along with the PSEiCARe model, were internally validated and calibration performance was provided for both models. The CAVS and CAVE models reported on the risk of late-onset seizures in patients with hemorrhagic stroke. The CAVS model derivation cohort was racially diverse. The CAVS model’s c-statistic was 0.76, while the CAVE model had a c-statistic of 0.81. Calibration and internal validation were not performed for either study. The CAVS model, created from a Finnish population, was externally validated in American and French cohorts, with c-statistics of 0.73 and 0.69, respectively. Finally, the two studies focusing on both types of stroke came from the PoSERS and INPOSE models. Neither model provided c-statistics, calibration metrics, internal or external validation information. We found no evidence of the presence of impact studies to assess the effect of adopting late-onset seizure risk models after stroke on clinical outcomes.

CONCLUSION: The SeLECT model was the only model developed in line with proposed guidelines for appropriate model development. The model, which was externally validated in a very similar and homogeneous population, may need to be tested in a more racially/ethnic diverse and younger population; testing the SeLECT model, accounting for overall brain health is likely to improve the identification of high-risk patients for late post stroke seizures.

PMID:34029995 | DOI:10.1016/j.yebeh.2021.108003

Phys Ther Sport. 2021 May 13;50:153-158. doi: 10.1016/j.ptsp.2021.05.004. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to evaluate the relationship between running performance goals and running-related injuries (RRIs).

DESIGN: Retrospective cross-sectional study.

SETTING: A total of 970 recreational runners filled in an online questionnaire to collect data on personal characteristics, their running activities, RRIs, and running goals.

PARTICIPANTS: 970 recreational runners, 1) without a running performance goal, who 2) trained to complete a certain distance, and who 3) trained to complete a certain distance and to participate in a specific running event.

MAIN OUTCOME MEASURES: RRI, defined as any physical complaint developed during running in the previous 12 months.

RESULTS: A statistically significant relationship was found between runners who trained for a specific running event and who also wanted to run a certain distance (OR 2.0, 95%CI 1.23-2.98) compared with runners without a running goal. (Hinder from a) Previous injury (OR 3.9, 95%CI 2.79-5.42), overweight (OR 1.6, 95%CI 1.10-2.21), and training for more than 22.5 h/year (OR 1.7, 95%CI 1.04-2.72 and OR 2.3, 95%CI 1.42-3.81) were also associated with RRIs.

CONCLUSION: Running to achieve running goals, specifically running to complete a certain distance and to participate in an event, is associated with the occurrence of an RRI.

PMID:34029987 | DOI:10.1016/j.ptsp.2021.05.004

Psychiatry Res. 2021 May 13;302:113991. doi: 10.1016/j.psychres.2021.113991. Online ahead of print.

ABSTRACT

Psychotic-like experiences (PLEs) are subclinical psychotic symptoms that occur outside the context of sleep or are unrelated to drug use. PLEs of varying severity are reportedly very common in adolescence. However, there are concerns about whether the structure of PLEs among adolescents is latently dimensional or categorical (“taxonic”). The current study investigates the latent structure of PLEs in 1,886 adolescents recruited from senior high schools in Ghana. Four multivariate taxometric procedures (MAMBAC, MAXEIG, l-Mode and MAXSLOPE) were applied to analyze the data. Across the taxometric procedures, there was evidence that a dimensional structure underpins positive PLEs, negative PLEs and a combination of positive and negative PLEs. The findings suggest that PLEs are distributed in the adolescent population at differing degrees/severity and that evidence of discontinuity between milder and more severe PLEs is non-existent. The findings highlight the importance of incorporating a dimensional assessment of PLEs into the existing categorical approach so that differences between people can been seen as quantitative variations along the PLEs continuum.

PMID:34029985 | DOI:10.1016/j.psychres.2021.113991

J Pharm Biomed Anal. 2021 May 18;202:114147. doi: 10.1016/j.jpba.2021.114147. Online ahead of print.

ABSTRACT

Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) acquired resistance remains a major barrier in the clinical treatment of lung adenocarcinoma with epidermal growth factor receptor (EGFR) mutations. Despite extensive efforts, mechanism of acquired resistance has not yet been elucidated clearly. The subject of this study was to characterize the metabolic signatures relevant to acquired EGFR-TKI resistance in pleural effusion (PE), and identify potential biomarkers in PE of patients with acquired EGFR-TKI resistance. PE from EGFR-TKI untreated group (n = 30) and EGFR-TKI resistant group (n = 18) was analyzed using liquid chromatography-mass spectrometry (LCMS) based metabolomic. Multivariate statistical analysis revealed distinctive diff ;erences between the groups. A total of 34 significantly differential metabolites in PE were identified, among which, the acquired EGFR-TKI resistant group had higher levels of l-lysine, taurine, ornithine and citrulline, and lower levels of l-tryptophan, kynurenine, l-phenylalanine, l-leucine, N-formyl-l-methionine, 3-hydroxyphenylacetic acid and N-acetyl-d-phenylalanine in PE than that of the EGFR-TKI untreated group. These metabolites are mainly involved in six amino acid metabolic pathways. In addition, 3-hydroxyphenylacetic acid and N-acetyl-d-phenylalanine showed the highest AUC values of 0.934 and 0.929 in receiver operating characteristic analysis. Through LCMS metabolomics, our study identified potential biomarkers in PE, differentiating EGFR-TKI resistant patients from untreated patients, as well as the mechanisms underlying acquired EGFR-TKI resistance; thus, providing novel insights into acquired EGFR-TKI resistance.

PMID:34029974 | DOI:10.1016/j.jpba.2021.114147

J Electromyogr Kinesiol. 2021 Apr 30;59:102554. doi: 10.1016/j.jelekin.2021.102554. Online ahead of print.

ABSTRACT

INTRODUCTION: Cervical extensor muscle (CEM) fatigue causes decrements in upper limb proprioceptive accuracy during constrained single-joint tasks. This study used a novel humeral rotation joint position sense (JPS) measurement device to compare JPS accuracy in participants who received acute CEM fatigue vs. non-fatigued controls.

METHODS: Participants had vision occluded and were passively guided into postures of internal humeral rotation from a baseline posture before and after a CEM fatigue or control protocol. Mixed model repeated measures ANOVAs were used to verify fatigue and compared absolute, constant, and variable JPS error between groups.

RESULTS: CEM fatigue was verified via pre-post reduction in CEM strength, and myoelectric indicators of fatigue. However, between-group comparisons of absolute, constant, and variable JPS error were not statistically significant, despite having large effect sizes.

DISCUSSION: Contrary to prevailing literature, unconstrained humeral rotation JPS did not appear to be affected by CEM fatigue in this study. However, between-group differences in JPS error were dwarfed by inter-trial variability, which likely arose due to the unconstrained nature of this task, conflating chances for a Type II error. Future research should perform a kinematic analysis of task constraints to highlight potential compensatory mechanisms obscuring significant findings in this otherwise robust effect.

PMID:34029973 | DOI:10.1016/j.jelekin.2021.102554

Schizophr Res. 2021 May 21;232:98-106. doi: 10.1016/j.schres.2021.05.008. Online ahead of print.

ABSTRACT

Gray matter and cortical thickness reductions have been documented in individuals at clinical high-risk for psychosis and may be more pronounced in those who transition to psychosis. However, these findings rely on small samples and are inconsistent across studies. In this review and meta-analysis we aimed to investigate neuroanatomical correlates of clinical high-risk for psychosis and potential predictors of transition, using a novel meta-analytic method (Seed-based d Mapping with Permutation of Subject Images) and cortical mask, combining data from surface-based and voxel-based morphometry studies. Individuals at clinical high-risk for psychosis who later transitioned to psychosis were compared to those who did not and to controls, and included three statistical maps. Overall, individuals at clinical high-risk for psychosis did not differ from controls, however, within the clinical high-risk for psychosis group, transition to psychosis was associated with less cortical gray matter in the right temporal lobe (Hedges’ g = -0.377), anterior cingulate and paracingulate (Hedges’ g = -0.391). These findings have the potential to help refine prognostic and etiopathological research in early psychosis.

PMID:34029948 | DOI:10.1016/j.schres.2021.05.008

Andrologia. 2021 May 24:e14125. doi: 10.1111/and.14125. Online ahead of print.

ABSTRACT

Recently, with the advancements in laser technology, Holmium laser enucleation of the prostate (HoLEP) and Thulium laser enucleation of the prostate (ThuLEP) have come to the fore in the surgical treatment of benign prostatic hyperplasia (BPH). We aimed to evaluate and compare the outcomes of HoLEP and ThuLEP in patients with >100 ml prostate volume. Patients who underwent HoLEP and ThuLEP between July 2017 and March 2020 were reviewed retrospectively. The patients were divided into two groups as HoLEP (Group 1, n = 121) and ThuLEP (Group 2, n = 104). Perioperative parameters, functional outcomes, continence status, intra and post-operative complications were compared between groups in the post-operative 1st and 6th month. No significant difference was found in terms of total laser energy (TLE), morcellation efficiency (ME), enucleated tissue weight (ETW), complication rates (CR) and continence status of patients between both groups (p > .05). In favour of ThuLEP group, there were statistically significant differences regarding total operation time (TOT), laser efficiency (LE), enucleation time (ET) and enucleation efficiency (EE) between groups (p ≤ .05). HoLEP and ThuLEP can be used safely and effectively in prostates larger than 100 ml.

PMID:34029399 | DOI:10.1111/and.14125