Nevin Manimala

J Cardiothorac Surg. 2024 Dec 30;19(1):689. doi: 10.1186/s13019-024-03211-x.

ABSTRACT

OBJECTIVES: Compare the differences in perioperative clinical characteristics of lung cancer patients of different genders who have undergone VATS lobectomy, and explore the impact of these differences on the short-term prognosis of patients.

METHODS: A total of 338 consecutive patients with lung cancer who underwent VATS lobectomy in our hospital from August 2021 to August 2022 were retrospectively analyzed, they were divided into male group and female group. The perioperative characteristics and short-term prognosis of different groups were compared. The multivariate binary logistic regression analysis was used to analyze the risk factors.

RESULTS: There were statistically significant differences between male and female patients in age of onset, body surface area (BSA), smoking rate, alcohol consumption rate, hypertension incidence, pulmonary function and clinical stage. There were statistically significant differences between male and female patients in operation time and lymph node dissection. The probability of postoperative complications, such as pulmonary infection, persistent air leakage and severe subcutaneous emphysema, in male patients was significantly higher than that in female patients. The average daily postoperative thoracic drainage volume in male patients was considerably higher than that in female patients, and the postoperative duration of thoracic drainage tube and hospital stay in male patients were significantly longer than those in female patients. After multiple regression analysis, low FEVI values in males was found to be an independent risk factor for postoperative complications.

CONCLUSIONS: Compared with female patients, male patients with lung cancer are more likely to have unfavorable factors such as older age, higher smoking rate, poor pulmonary function and late clinical stage of tumors when they undergoing VATS surgery treatment. The appropriate thoracic drainage time can be selected according to gender differences to shorten the length of hospital stay. The incidence of postoperative complications is higher in male patients, especially those with poor pulmonary function, and active perioperative intervention is required to reduce the incidence of postoperative complications.

PMID:39736652 | DOI:10.1186/s13019-024-03211-x

BMC Med Educ. 2024 Dec 30;24(1):1560. doi: 10.1186/s12909-024-06397-9.

ABSTRACT

BACKGROUND: In China, investigations into the efficacy of neurological clinical teaching try to ascertain the impacts of various teaching methods on intervention outcomes. However, these studies often suffer from limited sample sizes, single-center studies and low quality, compounded by the lack of direct comparative analyses between teaching methods, thereby leaving the identification of the most effective method unresolved. This study aims to compare the effectiveness of various teaching methods in the standardized training of Chinese neurology clinicians to inform an optimal teaching model utilizing a Bayesian network meta-analysis (NMA) approach.

METHODS: A comprehensive computer search was conducted to identify randomized controlled trials (RCTs) assessing the efficacy of 7 teaching methods: problem-based learning (PBL), case-based learning (CBL), flipped classroom model (FCM), evidence-based medicine (EBM), clinical practice (CP), team-based learning (TBL), and lecture-based learning (LBL). The search, which spanned databases including the China National Knowledge Infrastructure (CNKI), Chinese Citation Database (CDD), China Science Periodical Database (CSPD), Chinese BioMedical Literature Database (CBM), PubMed, Web of Science, and the Cochrane Library, covered the period from the inception of these databases to April 1, 2023. The quality of the included studies was evaluated, and the data were analyzed in R 4.3.2 and Stata 17.0 software.

RESULTS: From the 31 studies included, comprising 2124 subjects, significant findings emerged. In theoretical examinations, a statistically significant difference was noted among the teaching methods, with CBL, PBL, TBL, FCM, and EBM showing superior performance over the LBL method. The effectiveness ranking of these methods was as follows: CBL > PBL > TBL > FCM > EBM > CP > LBL. In terms of practical skills examinations, a similar pattern of effectiveness was observed. Here, the order of effectiveness was CBL > EBM > PBL > TBL > FCM > CP > LBL.

CONCLUSIONS: This NMA indicated that the modern teaching pedagogies, particularly CBL, could be effective in neurology education, and might help improve the theoretical examinations and practical skills of neurology clinicians. Fully tapping into the strengths of modern teaching methods in neurology teaching will require additional work and advancing research.

PMID:39736639 | DOI:10.1186/s12909-024-06397-9

Fluids Barriers CNS. 2024 Dec 30;21(1):108. doi: 10.1186/s12987-024-00611-y.

ABSTRACT

BACKGROUND: Disproportionately enlarged subarachnoid space hydrocephalus (DESH) is one of the neuroradiological characteristics of idiopathic normal pressure hydrocephalus (iNPH), which makes statistical analyses of brain images difficult. This study aimed to develop and validate methods of accurate brain segmentation and spatial normalisation in patients with DESH by using the Computational Anatomy Toolbox (CAT12).

METHODS: Two hundred ninety-eight iNPH patients with DESH and 25 healthy controls (HCs) who underwent cranial MRI were enrolled in this study. We selected the structural images of 169 patients to create customised tissue probability maps and diffeomorphic anatomical registration through exponentiated Lie algebra (DARTEL) templates for patients with DESH (DESH-TPM and DESH-Template). The structural images of 38 other patients were used to evaluate the validity of the DESH-TPM and DESH-Template. DESH-TPM and DESH-Template were created using the 114 well-segmented images after the segmentation processing of CAT12. In the validation study, we compared the accuracy of brain segmentation and spatial normalisation among three conditions: customised condition, applying DESH-TPM and DESH-Template to CAT12 and patient images; standard condition, applying the default setting of CAT12 to patient images; and reference condition, applying the default setting of CAT12 to HC images.

RESULTS: In the validation study, we identified three error types during segmentation. (1) The proportions of misidentifying the dura and/or extradural structures as brain structures in the customised, standard, and reference conditions were 10.5%, 44.7%, and 13.6%, respectively; (2) the failure rates of white matter hypointensity (WMH) cancellation in the customised, standard, and reference conditions were 18.4%, 44.7%, and 0%, respectively; and (3) the proportions of cerebrospinal fluid (CSF)-image deficits in the customised, standard, and reference conditions were 97.4%, 84.2%, and 28%, respectively. The spatial normalisation accuracy of grey and white matter images in the customised condition was the highest among the three conditions, especially in terms of superior convexity.

CONCLUSIONS: Applying the combination of the DESH-TPM and DESH-Template to CAT12 could improve the accuracy of grey and white matter segmentation and spatial normalisation in patients with DESH. However, this combination could not improve the CSF segmentation accuracy. Another approach is needed to overcome this challenge.

PMID:39736638 | DOI:10.1186/s12987-024-00611-y

Brief Funct Genomics. 2024 Dec 30:elae049. doi: 10.1093/bfgp/elae049. Online ahead of print.

ABSTRACT

OBJECTIVE: The primary objective of this study is to investigate various applications of artificial intelligence (AI) and statistical methodologies for analyzing and managing peritoneal metastases (PM) caused by gastrointestinal cancers.

METHODS: Relevant keywords and search criteria were comprehensively researched on PubMed and Google Scholar to identify articles and reviews related to the topic. The AI approaches considered were conventional machine learning (ML) and deep learning (DL) models, and the relevant statistical approaches included biostatistics and logistic models.

RESULTS: The systematic literature review yielded nearly 30 articles meeting the predefined criteria. Analyses of these studies showed that AI methodologies consistently outperformed traditional statistical approaches. In the AI approaches, DL consistently produced the most precise results, while classical ML demonstrated varied performance but maintained high predictive accuracy. The sample size was the recurring factor that increased the accuracy of the predictions for models of the same type.

CONCLUSIONS: AI and statistical approaches can detect PM developing among patients with gastrointestinal cancers. Therefore, if clinicians integrated these approaches into diagnostics and prognostics, they could better analyze and manage PM, enhancing clinical decision-making and patients’ outcomes. Collaboration across multiple institutions would also help in standardizing methods for data collection and allowing consistent results.

PMID:39736152 | DOI:10.1093/bfgp/elae049

Pol J Vet Sci. 2024 Sep;27(3):481-485. doi: 10.24425/pjvs.2024.151742.

ABSTRACT

Ultrasonographic renal length-to-aorta ratio is an ideal reflection of renal health in dogs. Earlier studies have highlighted the need for breed-specific reference intervals for this parameter. The aim of this study was to establish a breed-specific reference interval of kidney length to aorta ratio (KL:Ao) in Chippiparai dogs, a breed of Indian sighthounds. The KL:Ao ratio was recorded in 45 Chippiparai dogs, classified into 3 age groups. A narrow breed specific range of 7.07 to 7.74 was arrived at for adult Chippiparai dogs, and a strong relationship between age and body weight and KL:Ao was observed using regression analysis. These findings can be extrapolated and utilized by other sighthounds.

PMID:39736146 | DOI:10.24425/pjvs.2024.151742

Brief Funct Genomics. 2024 Dec 30:elae048. doi: 10.1093/bfgp/elae048. Online ahead of print.

ABSTRACT

When the traditional random forest (RF) algorithm is used to select feature elements in biostatistical data, a large amount of noise data and parameters can affect the importance of the selected feature elements, making the control of feature selection difficult. Therefore, it is a challenge for the traditional RF algorithm to preserve the accuracy of algorithm results in the presence of noise data. Generally, directly removing noise data can result in significant bias in the results. In this study, we develop a new algorithm, standardized threshold, and loops based random forest (STLBRF), and apply it to the field of gene expression data for feature gene selection. This algorithm, based on the traditional RF algorithm, combines backward elimination and K-fold cross-validation to construct a cyclic system and set a standardized threshold: error increment. The algorithm overcomes the shortcomings of existing gene selection methods. We compare ridge regression, lasso regression, elastic net regression, the traditional RF algorithm, and our improved RF algorithm using three real gene expression datasets and conducting a quantitative analysis. To ensure the reliability of the results, we validate the effectiveness of the genes selected by these methods using the Random Forest classifier. The results indicate that, compared to other methods, the STLBRF algorithm achieves not only higher effectiveness in feature gene selection but also better control over the number of selected genes. Our method offers reliable technical support for feature expression analysis and research on biomarker selection.

PMID:39736135 | DOI:10.1093/bfgp/elae048

Pol J Vet Sci. 2024 Sep;27(3):487-490. doi: 10.24425/pjvs.2024.151743.

ABSTRACT

The aim of this study was to evaluate the association between spontaneous echocardiographic contrast (SEC) and left atrial (LA) parameters such as size, volume, and function in cats with hypertrophic cardiomyopathy (HCM). Cats were assigned into following groups: clinically healthy cats (n=8), HCM without SEC (n=12), and HCM with SEC (n=8). Left atrial shortening fraction (LAFS%) and left atrial fractional area change (LAFAC) had statistical significance between groups. In conclusion, compared to the healthy individuals, the presence of a decreased trend in levels of LAFS% and LAFAC in HCMSEC cats could be a predictive marker for the thromboembolic risk assessment. Further studies enrolling the asymptomatic HCM cats need to be conducted to define a cut-off value of LAFS% and LAFAC before the SEC formation.

PMID:39736131 | DOI:10.24425/pjvs.2024.151743

Int J Lang Commun Disord. 2025 Jan-Feb;60(1):e13153. doi: 10.1111/1460-6984.13153.

ABSTRACT

BACKGROUND: Individuals with dementia have communication limitations resulting from cognitive impairments that define the syndrome. Whereas there are numerous cognitive assessments for individuals with dementia, there are far fewer communication assessments. The Profiling Communication Ability in Dementia (P-CAD) was developed to address this gap.

AIMS: The purpose of this study was to examine the concurrent validity, longitudinal validity and inter- and intra-rater reliability of the P-CAD in a population of people with dementia and their communication partners.

METHOD: The P-CAD was administered to 122 people with dementia and their communication partners in Ireland (n = 100) and Canada (n = 22), over a 12-month period. To establish concurrent validity of the P-CAD, scores were compared to scores obtained from existing standardized instruments including the Functional Linguistic Communication Inventory (FLCI), the Mini-Mental State Examination (MMSE-2) and Global Deterioration Scale (GDS). Inter-rater reliability and responsiveness (longitudinal validity) were analysed using data from a subgroup of participants.

OUTCOMES & RESULTS: Overall P-CAD test scores were significantly correlated with FLCI (n = 122; r = 0.875; p < 0.001) and MMSE-2 total scores (n = 122; r = 0.857; p < 0.001). Levels of communication support categories on the P-CAD correlated with GDS rankings (n = 122; rho = -0.539; p < 0.001) and MMSE-2 total scores (n = 122; rho = 0.680, p < 0.001). Inter-rater reliability tested for 20 participants in the Irish sample revealed high levels of agreement between raters in scoring the GDS (n = 20; ICC = 0.969, p < 0.001), MMSE-2 (n = 20; ICC = 0.997, p < 0.001), FLCI (n = 20; ICC = 0.999, p < 0.001) and P-CAD (n = 20; ICC = 0.981, p < 0.001). To establish longitudinal validity to examine if the P-CAD was responsive to changes in cognitive-communication function over time, 12 participants in the Irish sample repeated all tests 3 months after the initial testing. No statistically significant differences in test scores were found for the 12 participants who completed follow-up measures at this time point in any of the three scales. It was not possible to determine sufficient responsiveness as correlations between the change in P-CAD scores over 3 months were insignificant for both the change in MMSE-2 scores (rho = -0.130, p = 0.704) and the FLCI scores (rho = 0.221, p = 0.513).

CONCLUSIONS & IMPLICATIONS: In this study, P-CAD has demonstrated good concurrent validity and inter-rater reliability in samples collected in two countries with English-speaking participants. The P-CAD is appropriate for use to evaluate communication abilities of people with dementia, including during conversational interactions with caregivers.

WHAT THIS PAPER ADDS: What is already known on the subject Dementia alters the communication function of the person with dementia and impacts interactions with others. Speech and language therapists (SLTs) provide specific recommendations on communication function and support. However, they have limited access to comprehensive communication assessments to guide intervention. What this paper adds to the existing knowledge This validation study has confirmed that Profiling Communication Ability in Dementia (P-CAD) is a valid and reliable tool for SLTs to profile the communication abilities of people with dementia. It identifies the type and levels of communication support required as dementia progresses. The inclusion of communication partners in the study confirms their important role in providing conversation support to people with dementia. What are the potential or clinical implications of this work? The P-CAD is a clinical resource for dynamic communication assessment, which identifies key areas of retained ability to guide communication support and individualised intervention. It can be used with people at different stages and severity of dementia across a range of clinical settings. The P-CAD summary, which is part of the P-CAD, can be shared with family members and healthcare teams to enhance communication access for the person as dementia progresses.

PMID:39736087 | DOI:10.1111/1460-6984.13153

Pol J Vet Sci. 2024 Jun;27(2):261-270. doi: 10.24425/pjvs.2024.149356.

ABSTRACT

The aim of the study was to determine the thickness of choroidal layers in mixed breed dogs suffering from retinal atrophy (RA) and showing symptoms of progressive retinal atrophy (PRA), with the use of SD-OCT. The study was performed on 50 dogs divided into two groups: 25 dogs diagnosed with retinal atrophy (RA) with PRA symptoms aged 1.5-14 years and 25 healthy dogs aged 2-12 years. The dogs were examined using slit-lamp biomicroscopy, tonometry, ophthalmoscopy, fundus camera and SD-OCT (Topcon 3D OCT 2000). Measurements of the choroidal layers: RPE-Bruch membrane-choriocapillaris complex (RPE-BmCc) with tapetum lucidum in tapetal fundus, medium-sized vessel layer, (MSVL), large vessel layer with lamina suprachoroidea and (LVLS) whole choroidal thickness (WCT) were taken manually with the use of the caliper function integrated with the SD-OCT software. The measurements were performed dorsally (D) and ventrally (V) at a distance of 5000-6000 μm, and temporally (T) and nasally (N) at a distance of 4000-7000 μm from the optic disc with enhanced depth scans. The measurements were conducted temporally and nasally both in the tapetal (TempT, Nast) and nontapetal (TempNT, NasNT) fundus. Statistical analysis was performed using Statistica 10 software (Mann Whitney U Test). In all dogs affected by retinal atrophy (RA) with PRA symptoms, a statistically significant (p≤0.05) reduction in thickness of MSVL was observed in all the measured regions. A statistically significant reduction in thickness of LVLS and WCT was found in all nontapetal areas (p≤0.05). RA in mixed breed dogs with PRA symptoms was accompanied by choroid disorders such as reduction in thickness of the large vessel layer and decreased whole choroidal thickness in the nontapetal fundus as well as the medium vessel layer in all fundus regions.

PMID:39736068 | DOI:10.24425/pjvs.2024.149356

Pol J Vet Sci. 2024 Jun;27(2):211-220. doi: 10.24425/pjvs.2024.149351.

ABSTRACT

This study aimed to evaluate the effects of different dietary supplementation levels with jujube fruit powder on the performance, biochemical parameters, and egg quality characteristics of laying quails. A total of 60 quails (45 days old) were randomly assigned to treatments with different levels of jujube fruit powder: a basal diet (control) and diets supplemented with 5 g/kg (T1), 10 g/kg (T2), with five replicates per treatment (20 quails/treatment and four quails/replicate). The differences between 1-15 and 16-30 days for feed intake (p<0.05), 1-60 days for egg production (p<0.05), 16-30 days for egg weight (p<0.05), and 1-15 and 1-60 days for feed conversion ratio were statistically significant. The highest values for egg width (p<0.01) and egg length (p<0.05) were found in the control group (25.87 and 33.55 mm), while lower values were observed in the T1 and T2 groups. There was no statistical difference between the groups in egg shape index, shell weight, shell ratio, and shell thickness (p>0.05). The yolk height (p<0.05) and yolk diameter (p<0.01) were statistically significant. The differences between the groups for all serum biochemical parameters were insignificant (p>0.05). According to the results of this study, jujube fruit, a rich energy source, can be used as an alternative supplement in poultry diets with positive effects on egg production and feed conversion ratio.

PMID:39736063 | DOI:10.24425/pjvs.2024.149351