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Nevin Manimala Statistics

Combining HD-tDCS with music stimulation for patients with prolonged disorders of consciousness: Study protocol for an RCT trial

NeuroRehabilitation. 2024 Mar 2. doi: 10.3233/NRE-230282. Online ahead of print.

ABSTRACT

BACKGROUND: Patients with prolonged disorders of consciousness (pDOC) pose significant challenges to healthcare workers due to their severe motor impairments and limited interaction with the environment. Non-invasive brain stimulation such as high-definition transcranial direct current stimulation (HD-tDCS) and music stimulation show promise in awakening this population.

OBJECTIVE: In this study, we present a protocol aiming at investigating the efficacy of combined HD-tDCS and music stimulation in awakening patients with pDOC through a single-blind, randomized controlled trial.

METHODS: Ninety patients with pDOC will be randomly divided into three groups: active HD-tDCS with music stimulation, active HD-tDCS, and sham HD-tDCS. All participants will receive 20 treatment sessions over a period of 10 days and the Coma Recovery Scale-Revised, Glasgow Outcome Scale and electroencephalogram will be used as assessment measures to evaluate their level of consciousness throughout the study. Adverse events and complications will be recorded during treatment. Within-group pre-post comparisons and between-group efficacy comparisons will be conducted to identify the most effective intervention approach. Statistical analysis will be performed using SPSS software with a significance level set at P < 0.05.

CONCLUSION: The pursuit of awakening therapy for patients with pDOC remains a clinical research challenge. This study protocol is designed with the aim of introducing an innovative non-pharmacological approach which combined HD-tDCS and music stimulation to facilitate the reinstatement of consciousness in patients with pDOC.

PMID:38457160 | DOI:10.3233/NRE-230282

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Nevin Manimala Statistics

The association of microRNAs in the development of retinopathy of prematurity

J Neonatal Perinatal Med. 2024;17(1):49-55. doi: 10.3233/NPM-230029.

ABSTRACT

INTRODUCTION: Retinopathy of prematurity (ROP) is one of the main reasons of preventable childhood blindness. In the development of ROP, MicroRNAs may be effective in the balance of factors that inhibit and activate angiogenic factors. We aimed to determine the changes in the blood levels of miR-146a, miR-143, miR-210, miR-21, miR-126, miR-211, miR-221, miR-106 and let 7f and to investigate their association with ROP. We hypothesed that the level of these miRNAs changed significantly in ROP cases.

MATERIALS AND METHODS: This observational study was conducted prospectively in preterm infants with ROP. Serum levels of 8 miRNAs were measured. The relationship between disease stage and progression with miRNA gene expression was analysed. Preterm infants without ROP were taken as the control group.

RESULTS: 47 patients with ROP and 14 controls, were included in the study. In the ROP group, miR-210, miR-146a, miR-21 were statistically significantly lower. In the ROP group the expression level of miR-143 was insignificantly lower, miRNA-221 was insignificantly higher, and miR-106, miR-126 and let 7f were variable.

CONCLUSION: It was observed that miR-210, miR-146a, miR-21 and miR-143 were significantly lower in patients with ROP compared to the control group. However, no association could be established between the type of miRNA and stage of ROP. These miRNAs may be used as adjunctive biomarkers for diagnosis of ROP.

PMID:38457157 | DOI:10.3233/NPM-230029

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Nevin Manimala Statistics

Investigating the Shared Genetic Etiology Between Parkinson’s Disease and Depression

J Parkinsons Dis. 2024 Mar 5. doi: 10.3233/JPD-230176. Online ahead of print.

ABSTRACT

BACKGROUND: Depression is a common symptom in Parkinson’s disease (PD), resulting from underlying neuropathological processes and psychological factors. However, the extent to which shared genetic risk factors contribute to the relationship between depression and PD is poorly understood.

OBJECTIVE: To examine the effects of common genetic variants influencing the etiology of PD and depression risk at the genome-wide and local genomic regional level.

METHODS: We comprehensively investigated the genetic relationship between PD and depression using genome-wide association studies data. First, we estimated the genetic correlation at the genome-wide level using linkage-disequilibrium score regression, followed by local genetic correlation analysis using the GWAS-pairwise method and functional annotation to identify genes that may jointly influence the risk for both traits. Also, we performed Latent Causal Variable, Latent Heritable Confounder Mendelian Randomization, and traditional Mendelian Randomization analyses to investigate the potential causal relationship.

RESULTS: Although the genetic correlation between PD and depression was not statistically significant at the genome-wide level, GWAS-pairwise analyses identified 16 genomic segments associated with PD and depression, implicating nine genes. Further analyses revealed distinct patterns within individual genes, suggesting an intricate pattern. These genes involve various biological processes, including neurotransmitter regulation, senescence, and nucleo-cytoplasmic transport mechanisms. We did not observe genetic evidence of causality between PD and depression.

CONCLUSIONS: Our findings did not support a genome-wide genetic correlation or a causal association between both conditions. However, we identified genomic segments but identified genomic segments linked to distinct biological pathways influencing their etiology.Further research is needed to understand their functional consequences.

PMID:38457145 | DOI:10.3233/JPD-230176

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Nevin Manimala Statistics

Risk Factors of Open Surgery Conversion in Laparoscopic Partial Nephrectomy to Achieve Nephron Sparing

Ann Surg Oncol. 2024 Mar 8. doi: 10.1245/s10434-024-15106-1. Online ahead of print.

ABSTRACT

OBJECTIVES: We aimed to evaluate the risk factors for the conversion from laparoscopic partial nephrectomy (LPN) to open surgery to achieve partial nephrectomy (PN).

METHODS: Data from patients who underwent LPN between June 2020 and September 2023 were analyzed retrospectively. Patients in whom the PN procedure could be completed laparoscopically were recorded as the ‘Fully Laparoscopic’ (FL) group (n = 97), and those converted to open surgery from laparoscopy were recorded as the ‘Conversion to Open’ (CTO) group (n = 10). The demographic and pathologic variables were compared between groups. Regression analyses were used to define predictor factors, and receiver operating characteristic analysis was used to define the cut-off value of the surgical bleeding volume.

RESULTS: Conversion to open surgery was found in 10/107 patients (9.3%). There was no statistical difference between groups in demographic and pathologic variables. Intraoperative blood loss volume, upper pole localized tumor, and posterior localized tumor were found to be statistically higher in the CTO group (p = 0.001, p = 0.001, and p = 0.043, respectively). Furthermore, these factors were only found to be statistically significant predictors of conversion to open surgery in both univariate and multivariate regression analyses. 235 cc was found to be the cut-off value of intraoperative blood loss volume for predicting conversion to open surgery (p = 0.001).

CONCLUSION: Using these predictive factors in clinical practice, treatment planning will lead to the possibility of starting the treatment directly with open surgery instead of minimally invasive options, and it may also provide a chance of being prepared for the possibility of conversion to open surgery peroperatively.

PMID:38457100 | DOI:10.1245/s10434-024-15106-1

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Nevin Manimala Statistics

Influence of systemic antibiotic therapy on the development and progression of induced apical periodontitis in Wistar rats

Odontology. 2024 Mar 8. doi: 10.1007/s10266-024-00908-2. Online ahead of print.

ABSTRACT

The aim of this study was to investigate the influence of systemic antibiotic therapy on the development and progression of induced apical periodontitis (AP) in Wistar rats. Fifty-six rats were submitted to pulp exposure of the lower left first molar for the induction of AP. On the same day, intraperitoneal antibiotic therapy was administered once a day, for 15 days, until euthanasia. The groups were formed according to the different treatments (n = 8): C-control; GEN-treated with gentamicin (10 mg/Kg); AC-treated with amoxicillin (100 mg/Kg); MZ-treated with metronidazole (40 mg/Kg); AMP-treated with ampicillin (100 mg/Kg); AMC group-treated with amoxicillin + clavulanic acid (100 mg/kg); CLI-treated with clindamycin (60 mg/kg). After euthanasia, the jaws were collected and processed for (1) histological and histometric analysis using hematoxylin and eosin staining, (2) analysis of collagen fibers using Picrosirius Red staining and (3) bacteriological analysis using Brown-Brenn staining. The data were analyzed statistically (p < 0.05). AP induction was confirmed in all groups. The AMC group had the lower intensity of inflammatory infiltrate (p = 0.028) and less periapical bone resorption compared to control (p = 0.006). Regarding collagen maturation, PSR staining revealed a predominance of mature collagen fibers in all groups. The AC and AMC groups had the lower amount of mature fibers and the highest amount of immature fibers, compared to all other groups (p < 0.001). All groups showed bacterial contamination; however, the AC and AMC groups showed a lower extent of bacterial contamination compared to the control (p < 0.001). It can be concluded that systemic antibiotic therapy influences the development and progression of induced AP.

PMID:38457086 | DOI:10.1007/s10266-024-00908-2

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Nevin Manimala Statistics

Sex differences in patients with and without high-risk factors associated with aneurysmal subarachnoid hemorrhage

Acta Neurochir (Wien). 2024 Mar 8;166(1):125. doi: 10.1007/s00701-024-06021-1.

ABSTRACT

BACKGROUND: Controversy remains regarding the appropriate screening for intracranial aneurysms or for the treatment of aneurysmal subarachnoid hemorrhage (aSAH) for patients without known high-risk factors for rupture. This study aimed to assess how sex affects both aSAH presentation and outcomes for aSAH treatment.

METHOD: A retrospective cohort study was conducted of all patients treated at a single institution for an aSAH during a 12-year period (August 1, 2007-July 31, 2019). An analysis of women with and without high-risk factors was performed, including a propensity adjustment for a poor neurologic outcome (modified Rankin Scale [mRS] score > 2) at follow-up.

RESULTS: Data from 1014 patients were analyzed (69% [n = 703] women). Women were significantly older than men (mean ± SD, 56.6 ± 14.1 years vs 53.4 ± 14.2 years, p < 0.001). A significantly lower percentage of women than men had a history of tobacco use (36.6% [n = 257] vs 46% [n = 143], p = 0.005). A significantly higher percentage of women than men had no high-risk factors for aSAH (10% [n = 70] vs 5% [n = 16], p = 0.01). The percentage of women with an mRS score > 2 at the last follow-up was significantly lower among those without high-risk factors (34%, 24/70) versus those with high-risk factors (53%, 334/633) (p = 0.004). Subsequent propensity-adjusted analysis (adjusted for age, Hunt and Hess grade, and Fisher grade) found no statistically significant difference in the odds of a poor outcome for women with or without high-risk factors for aSAH (OR = 0.7, 95% CI = 0.4-1.2, p = 0.18).

CONCLUSIONS: A higher percentage of women versus men with aSAH had no known high-risk factors for rupture, supporting more aggressive screening and management of women with unruptured aneurysms.

PMID:38457080 | DOI:10.1007/s00701-024-06021-1

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Nevin Manimala Statistics

Image reconstruction method for incomplete CT projection based on self-guided image filtering

Med Biol Eng Comput. 2024 Mar 8. doi: 10.1007/s11517-024-03044-9. Online ahead of print.

ABSTRACT

In some fields of medical diagnosis or industrial nondestructive testing, it is difficult to obtain complete computed tomography (CT) data due to the limitation of radiation dose or other factors. Therefore, image reconstruction of incomplete projection data is the focus of this paper. In this paper, a new image reconstruction model based on self-guided image filtering (SGIF) term is proposed for few-view and segmental limited-angle (SLA) CT reconstruction. Then the alternating direction method (ADM) is used to solve this model. For simplicity, we call it ADM-SGIF method. The key idea of ADM-SGIF method is to use the reconstructed image itself as a reference and utilize its structural features to guide CT reconstruction. This method can effectively preserve image structures and remove shading artifacts. To validate the effectiveness of the proposed reconstruction method, we conduct digital phantom and real CT data experiments. The results indicate that ADM-SGIF method outperforms competing methods, including total variation (TV), relative total variation (RTV), and L0-norm minimization solved by ADM (ADM-L0) methods, in both subjective and objective evaluations.

PMID:38457068 | DOI:10.1007/s11517-024-03044-9

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Nevin Manimala Statistics

When better is the enemy of good: two cautionary tales of conceptual validity versus parsimony in clinical psychometric research

Qual Life Res. 2024 Mar 8. doi: 10.1007/s11136-024-03617-z. Online ahead of print.

ABSTRACT

This paper presents an empirical challenge to the assumption that an item-response theory analysis always yields a better measure of a clinical construct. We summarize results from two measurement development studies that showed that such an analysis lost important content reflecting the conceptual model (“conceptual validity”). The cost of parsimony may thus be too high. Conceptual models that form the foundation of QOL measurement reflect the patient’s experience. This experience may include concepts and items that are psychometrically “redundant” but capture distinct features of the concept. Good measurement is likely a balance between relying on IRT’s quantitative metrics and recognizing the importance of conceptual validity and clinical utility.

PMID:38457054 | DOI:10.1007/s11136-024-03617-z

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Nevin Manimala Statistics

Health-related quality of life and associated risk factors in patients with Multiple Osteochondromas: a cross-sectional study

Qual Life Res. 2024 Mar 8. doi: 10.1007/s11136-024-03604-4. Online ahead of print.

ABSTRACT

PURPOSE: To evaluate the health-related quality of life and associated risk factors for Multiple Osteochondromas patients.

METHODS: A cross-sectional, observational study was conducted from May to December 2022 during the routine visit to the referral center for rare skeletal disorders. All patients with Multiple Osteochondromas aged ≥ 3 years were included. EuroQol 5-dimension questionnaires, and demographic, clinical, and surgical history data were collected. Descriptive statistics, Fisher’s exact test, One-sample t-test, Spearman’s correlation, and multiple linear and logistic regression were performed to analyze the data. Results are reported following STROBE guidelines.

RESULTS: A total of 128 patients were included in the study, with a mean age of 14 [SD, 10] years. The mean EQ-5D Index Value was 0.863 [SD, 0.200] and the EQ-VAS was 84 [SD, 19] with a positive correlation between two scores [r = 0.541, p < 0.001]. Patients frequently referred problems in pain/discomfort [78.8%], anxiety/depression [50%], and usual activities [38.8%] dimensions. Increasing age was the common risk factor for health-related quality of life [p < 0.000], as well as Index Value and VAS scores were significantly lower in surgical patients [p = 0.001 and p < 0.001, respectively].

CONCLUSION: Increasing age and surgical procedures were found highly associated with reduced health-related quality of life in Multiple Osteochondromas patients. Our findings provide relevant information to support the establishment of patient-centered healthcare pathways and pave the way for further research into medical and non-medical therapeutic strategies for these patients.

PMID:38457053 | DOI:10.1007/s11136-024-03604-4

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Nevin Manimala Statistics

Molecular identification, risk factor assessment, and phylogenetic analysis of tick-borne pathogens in symptomatic and asymptomatic cattle from South-Eastern Iran

Exp Appl Acarol. 2024 Mar 8. doi: 10.1007/s10493-023-00886-0. Online ahead of print.

ABSTRACT

Tick-borne pathogens (TBPs) represent a substantial threat to cattle globally, exerting adverse impacts on production, health, and economic viability. This study delves into the prevalence and implications of TTBPs in cattle sourced from resource-limited smallholder livestock farms situated in southeastern Iran, proximate to Afghanistan and Pakistan. Blood and tick specimens were systematically collected from a cohort of 230 cattle, comprising 150 asymptomatic and 80 symptomatic individuals. Genomic DNA isolated from blood samples underwent rigorous examination for the presence of key TBPs, including Anaplasma marginale, A. phagocytophilum, A. bovis, A. centrale, Babesia bigemina, and Theileria annulata, utilizing multiple genetic markers. Nucleotide sequence analysis facilitated the reconstruction of phylogenetic relationships. The study also evaluated various potential risk factors, such as clinical status, gender, age, breed, tick infestation, and management practices, to elucidate their associations with TTBPs. Among the cattle cohort, a staggering 87.8% (202/230) tested positive for at least one pathogen. Prevalence statistics encompassed A. marginale (72.2%), T. annulata (68.3%), A. phagocytophilum/A. platys-like complex (66.1%), A. centrale (16.7%), B. bigemina (10.0%), and A. bovis (6.1%). Remarkably, mixed infections involving two, three, and four pathogens were detected in 23%, 52.1%, and 2.2% of animals, respectively. Notably, all asymptomatic cattle were positive for at least one TBP. Tick infestation was observed in 62.2% (143/230) of cattle, predominantly caused by Hyalomma anatolicum (82.5%), Rhipicephalus (Boophilus) annulatus (13.1%), and R. sanguineus sensu lato (4.4%). Risk factors linked to TBPs encompassed tick infestation, older age, and crossbred animals. Clinical presentations among symptomatic cattle encompassed fever, anemia, weight loss, anorexia, jaundice, and enlarged superficial lymph nodes. This study underscores the pivotal role of asymptomatic carriers in the propagation of TTBPs within endemic regions. Furthermore, it emphasizes the potential for the implementation of molecular diagnostics to unmask subclinical infections, thereby affording the opportunity for targeted interventions aimed at ameliorating the burden of TTBPs in resource-constrained smallholder dairy farms.

PMID:38457048 | DOI:10.1007/s10493-023-00886-0