Nevin Manimala

PLoS One. 2024 Mar 12;19(3):e0299649. doi: 10.1371/journal.pone.0299649. eCollection 2024.

ABSTRACT

PURPOSE: The research objective of this study is to use finite element analysis to investigate the impact of anterior cruciate ligament (ACL) injury on medial unicompartmental knee arthroplasty (UKA) and explore whether patients with ACL injuries can undergo UKA.

METHODS: Based on the morphology of the ACL, models of ACL with diameters ranging from 1 to 10mm are created. Finite element models of UKA include ACL absence and ACLs with different diameters. After creating a complete finite element model and validating it, four different types of loads are applied to the knee joint. Statistical analysis is conducted to assess the stress variations in the knee joint structure.

RESULTS: A total of 11 finite element models of UKA were established. Regarding the stress on the ACL, as the diameter of the ACL increased, when a vertical load of 750N was applied to the femur, combined with an anterior tibial load of 105N, the stress on the ACL increased from 2.61 MPa to 4.62 MPa, representing a 77.05% increase. Regarding the equivalent stress on the polyethylene gasket, a notable high stress change was observed. The stress on the gasket remained between 12.68 MPa and 14.33 MPa in all models. the stress on the gasket demonstrated a decreasing trend. The equivalent stress in the lateral meniscus and lateral femoral cartilage decreases, reducing from the maximum stress of 4.71 MPa to 2.61 MPa, with a mean value of 3.73 MPa. This represents a reduction of 44.72%, and the statistical significance is (P < 0.05). However, under the other three loads, there was no significant statistical significance (P > 0.05).

CONCLUSION: This study suggests that the integrity of the ACL plays a protective role in performing medial UKA. However, this protective effect is limited when performing medial UKA. When the knee joint only has varying degrees of ACL injury, even ACL rupture, and the remaining structures of the knee joint are intact with anterior-posterior stability in the knee joint, it should not be considered a contraindication for medial UKA.

PMID:38470904 | DOI:10.1371/journal.pone.0299649

PLoS One. 2024 Mar 12;19(3):e0300139. doi: 10.1371/journal.pone.0300139. eCollection 2024.

ABSTRACT

Adolescence is a sensitive developmental period for neural sex/gender differentiation. The present study used multiparametric mapping to better characterize adolescent white matter (WM) microstructure. WM microstructure was investigated using diffusion tensor indices (fractional anisotropy; mean, radial, and axial diffusivity [AD]) and quantitative T1 relaxometry (T1) in hormone therapy naïve adolescent cisgender girls, cisgender boys, and transgender boys (i.e., assigned female at birth and diagnosed with gender dysphoria). Diffusion indices were first analyzed for group differences using tract-based spatial statistics, which revealed a group difference in AD. Thus, two multiparametric and multivariate analyses assessed AD in conjunction with T1 relaxation time, and with respect to developmental proxy variables (i.e., age, serum estradiol, pubertal development, sexual attraction) thought to be relevant to adolescent brain development. The multivariate analyses showed a shared pattern between AD and T1 such that higher AD was associated with longer T1, and AD and T1 strongly related to all five developmental variables in cisgender boys (10 significant correlations, r range: 0.21-0.73). There were fewer significant correlations between the brain and developmental variables in cisgender girls (three correlations, r range: -0.54-0.54) and transgender boys (two correlations, r range: -0.59-0.77). Specifically, AD related to direction of sexual attraction (i.e., gynephilia, androphilia) in all groups, and T1 related to estradiol inversely in cisgender boys compared with transgender boys. These brain patterns may be indicative of less myelination and tissue density in cisgender boys, which corroborates other reports of protracted WM development in cisgender boys. Further, these findings highlight the importance of considering developmental trajectory when assessing the subtleties of neural structure associated with variations in sex, gender, and sexual attraction.

PMID:38470896 | DOI:10.1371/journal.pone.0300139

PLoS One. 2024 Mar 12;19(3):e0294020. doi: 10.1371/journal.pone.0294020. eCollection 2024.

ABSTRACT

Despite the common belief that police presence reduces crime, there is mixed evidence of such causal effects in major Latin America cities. In this work we identify the casual relationship between police presence and criminal events by using a large dataset of a randomized controlled police intervention in Bogotá D.C., Colombia. We use an Instrumental Variables approach to identify the causal effect of interest. Then we consistently estimate a Conditional Logit discrete choice model with aggregate data that allow us to identify agents’ utilities for crime location using Two Stage Least Squares. The estimated parameters allow us to compute the police own and cross-elasticities of crime for each of the spatial locations and to evaluate different police patrolling strategies. The elasticity of crime to police presence is, on average across spatial locations, -0.26 for violent crime, -0.38 for property crime and -0.38 for total crime, all statistically significant. Estimates of cross-elasticities are close to zero; however, spillover effects are non-negligible. Counterfactual analysis of different police deployment strategies show, for an optimal allocating algorithm, an average reduction in violent crime of 7.09%, a reduction in property crimes of 8.48% and a reduction in total crimes of 5.15% at no additional cost. These results show the potential efficiency gains of using the model to deploy police resources in the city without increasing the total police time required.

PMID:38470894 | DOI:10.1371/journal.pone.0294020

PLoS One. 2024 Mar 12;19(3):e0300369. doi: 10.1371/journal.pone.0300369. eCollection 2024.

ABSTRACT

Accurate assessment of kidney function in children requires age and gender-specific reference ranges for serum creatinine. Traditional reference values, often derived from adult populations and different ethnic backgrounds, may not be suitable for children. This study aims to establish specific reference ranges for serum creatinine in the Thai pediatric population, addressing the gap in localized and age-appropriate diagnostic criteria. This retrospective study analyzed serum creatinine levels from Thai children aged newborn to 18 years, collected from the Laboratory Information System of the Queen Sirikit National Institute of Child Health from January 2017 to December 2021. The Bhattacharya method was employed to establish reference ranges, considering different age groups and genders. The study compared these newly established reference values with international studies, including those of Schlebusch H., Pottel H., and Chuang GT., to validate their relevance and accuracy. A total of 27,642 data entries (15,396 males and 12,246 females) were analyzed. The study established distinct reference ranges for serum creatinine, which varied significantly across different age groups and between genders. These ranges were found to gradually increase with age from 2 months to 18 years. The study also highlighted notable differences in reference values when compared with other ethnic populations. The study successfully establishes tailored reference ranges for serum creatinine in Thai children, providing a valuable tool for more accurate diagnosis and monitoring of kidney health in this demographic. This initiative marks a significant advancement in pediatric nephrology in Thailand and suggests a need for continuous refinement of these ranges and further research in this area.

PMID:38470876 | DOI:10.1371/journal.pone.0300369

Aesthet Surg J. 2024 Mar 12:sjae056. doi: 10.1093/asj/sjae056. Online ahead of print.

ABSTRACT

BACKGROUND: Hymenoplasty, the surgical hymen reconstruction, is on the rise in Turkey, reflecting the enduring importance of virginity rooted in sociocultural and religious beliefs. Demographic factors shape women’s decisions for this procedure. A seven-year retrospective analysis of 4259 patient records at a private clinic explores motivations and societal pressures, emphasizing the need for understanding and support amidst the cultural fixation on virginity.

OBJECTIVES: This investigation delves into multifaceted perceptions around virginity and hymenoplasty in Turkey, examining the impact of sociocultural and religious beliefs on women’s decisions. It also explores demographic influences, offering insights into the societal and cultural backdrop of hymenoplasty.

METHODS: A retrospective analysis of 4259 patient records (2015-2022) at a private clinic was conducted, meticulously analyzing data for demographics and shared decision-making dynamics using statistical tools.

RESULTS: In the examined cohort (83.3%), permanent hymenoplasty was prevalent among individuals aged 14-49, with 58.6% being engaged and seeking the procedure a week before marriage. Notably, 91.0% were accompanied by friends during consultations, and a minority disclosed childbirth history or forced intercourse experiences. An increasing trend in first-time and post-assault hymenoplasty procedures was observed in 2021. Geographically, the majority resided in Istanbul, representing all Turkish regions. Additional procedures like vaginoplasty were common, with mostly successful postprocedural outcomes and minor complications.

CONCLUSIONS: This study highlights the enduring social importance of virginity in Turkey, emphasizing hymenoplasty as a coping strategy for psychological and societal challenges. It calls for comprehensive patient support and societal progress in respecting women’s bodily autonomy, urging a shift away from the cultural fixation on virginity.

PMID:38470862 | DOI:10.1093/asj/sjae056

Dalton Trans. 2024 Mar 12. doi: 10.1039/d4dt00610k. Online ahead of print.

ABSTRACT

Three non-symmetrical segmental ligand strands L4 can be wrapped around a linear sequence of one Zn²⁺ and two trivalent lanthanide cations Ln³⁺ to give quantitatively directional [ZnLn₂(L4)₃]⁸⁺ triple-stranded helicates in the solid state and in solution. NMR speciations in CD₃CN show negligible decomplexation at a millimolar concentration and the latter helicate can be thus safely considered as a preorganized C₃-symmetrical HHH-[(L4₃Zn)(Ln^A)_(2-n)(Ln^B)_n]⁸⁺ platform in which the thermodynamic properties of (i) lanthanide permutation between the central N₉ and the terminal N₆O₃ binding sites and (ii) exchange processes between homo- and heterolanthanide helicates are easy to access (Ln = La, Eu, Lu). Deviations from statistical distributions could be programmed by exploiting specific site recognition and intermetallic pair interactions. Considering the challenging La³⁺ : Eu³⁺ ionic pair, for which the sizes of the two cations differ by only 8%, a remarkable excess (70%) of the heterolanthanide is produced, together with a preference for the formation of the isomer where the largest lanthanum cation lies in the central N₉ site ([(La)(Eu)] : [(Eu)(La)] = 9 : 1). This rare design and its rational programming pave the way for the preparation of directional light-converters and/or molecular Q-bits at the (supra)molecular level.

PMID:38470853 | DOI:10.1039/d4dt00610k

Eur J Microbiol Immunol (Bp). 2024 Mar 12. doi: 10.1556/1886.2024.00015. Online ahead of print.

ABSTRACT

INTRODUCTION: APC and TP53 are the two most regularly mutated genes in colon adenocarcinoma (COAD), especially in progressive malignancies and antitumoral immune response. The current bioinformatics analysis investigates the APC and TP53 gene expression profile in colon adenocarcinoma as a prognostic characteristic for survival, particularly concentrating on the correlated immune microenvironment.

METHODS: Clinical and genetic data of colon cancer and normal tissue samples were obtained from The Cancer Genome Atlas (TCGA)-COAD and Genotype-Tissue Expression (GTEx) online databases, respectively. The genetic differential expressions were analyzed in both groups via the one-way ANOVA test. Kaplan-Meier survival curves were applied to estimate the overall survival (OS). P < 0.05 was fixed as statistically significant. On Tumor Immune Estimation Resource and Gene Expression Profiling Interactive Analysis databases, the linkage between immune cell recruitment and APC and TP53 status was assessed through Spearman’s correlation analysis.

RESULTS: APC and TP53 were found mutated in 66.74% and 85.71% of the 454 and 7 TCGA-COAD patients in colon and rectosigmoid junction primary sites, respectively with a higher log2-transcriptome per million reads compared to the GTEx group (318 samples in sigmoid and 368 samples in transverse). Survival curves revealed a worse significant OS for the high-APC and TP53 profile colon. Spearman’s analysis of immune cells demonstrated a strong positive correlation between the APC status and infiltration of T cell CD4+, T cell CD8+, NK cell, and macrophages and also a positive correlation between status and infiltration of T cell CD4+, T cell CD8+.

CONCLUSIONS: APC and TP53 gene mutations prevail in colon cancer and are extremely associated with poor prognosis and shortest survival. The infiltrating T cell CD4+, T cell CD8+, NK cell, and macrophages populate the colon microenvironment and regulate the mechanisms of tumor advancement, immune evasion, and sensitivity to standard chemotherapy. More comprehensive research is needed to demonstrate these results and turn them into new therapeutic outlooks.

PMID:38470482 | DOI:10.1556/1886.2024.00015

JMIR Res Protoc. 2024 Mar 12;13:e54593. doi: 10.2196/54593.

ABSTRACT

BACKGROUND: Computer-assisted clinical coding (CAC) tools are designed to help clinical coders assign standardized codes, such as the ICD-10 (International Statistical Classification of Diseases, Tenth Revision), to clinical texts, such as discharge summaries. Maintaining the integrity of these standardized codes is important both for the functioning of health systems and for ensuring data used for secondary purposes are of high quality. Clinical coding is an error-prone cumbersome task, and the complexity of modern classification systems such as the ICD-11 (International Classification of Diseases, Eleventh Revision) presents significant barriers to implementation. To date, there have only been a few user studies; therefore, our understanding is still limited regarding the role CAC systems can play in reducing the burden of coding and improving the overall quality of coding.

OBJECTIVE: The objective of the user study is to generate both qualitative and quantitative data for measuring the usefulness of a CAC system, Easy-ICD, that was developed for recommending ICD-10 codes. Specifically, our goal is to assess whether our tool can reduce the burden on clinical coders and also improve coding quality.

METHODS: The user study is based on a crossover randomized controlled trial study design, where we measure the performance of clinical coders when they use our CAC tool versus when they do not. Performance is measured by the time it takes them to assign codes to both simple and complex clinical texts as well as the coding quality, that is, the accuracy of code assignment.

RESULTS: We expect the study to provide us with a measurement of the effectiveness of the CAC system compared to manual coding processes, both in terms of time use and coding quality. Positive outcomes from this study will imply that CAC tools hold the potential to reduce the burden on health care staff and will have major implications for the adoption of artificial intelligence-based CAC innovations to improve coding practice. Expected results to be published summer 2024.

CONCLUSIONS: The planned user study promises a greater understanding of the impact CAC systems might have on clinical coding in real-life settings, especially with regard to coding time and quality. Further, the study may add new insights on how to meaningfully exploit current clinical text mining capabilities, with a view to reducing the burden on clinical coders, thus lowering the barriers and paving a more sustainable path to the adoption of modern coding systems, such as the new ICD-11.

TRIAL REGISTRATION: clinicaltrials.gov NCT06286865; https://clinicaltrials.gov/study/NCT06286865.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/54593.

PMID:38470476 | DOI:10.2196/54593

JMIR Mhealth Uhealth. 2024 Mar 12;12:e50135. doi: 10.2196/50135.

ABSTRACT

BACKGROUND: Despite its importance to women’s reproductive health and its impact on women’s daily lives, the menstrual cycle, its regulation, and its impact on health remain poorly understood. As conventional clinical trials rely on infrequent in-person assessments, digital studies with wearable devices enable the collection of longitudinal subjective and objective measures.

OBJECTIVE: The study aims to explore the technical feasibility of collecting combined wearable and digital questionnaire data and its potential for gaining biological insights into the menstrual cycle.

METHODS: This prospective observational cohort study was conducted online over 12 weeks. A total of 42 cisgender women were recruited by their local gynecologist in Berlin, Germany, and given a Fitbit Inspire 2 device and access to a study app with digital questionnaires. Statistical analysis included descriptive statistics on user behavior and retention, as well as a comparative analysis of symptoms from the digital questionnaires with metrics from the sensor devices at different phases of the menstrual cycle.

RESULTS: The average time spent in the study was 63.3 (SD 33.0) days with 9 of the 42 individuals dropping out within 2 weeks of the start of the study. We collected partial data from 114 ovulatory cycles, encompassing 33 participants, and obtained complete data from a total of 50 cycles. Participants reported a total of 2468 symptoms in the daily questionnaires administered during the luteal phase and menses. Despite difficulties with data completeness, the combined questionnaire and sensor data collection was technically feasible and provided interesting biological insights. We observed an increased heart rate in the mid and end luteal phase compared with menses and participants with severe premenstrual syndrome walked substantially fewer steps (average daily steps 10,283, SD 6277) during the luteal phase and menses compared with participants with no or low premenstrual syndrome (mean 11,694, SD 6458).

CONCLUSIONS: We demonstrate the feasibility of using an app-based approach to collect combined wearable device and questionnaire data on menstrual cycles. Dropouts in the early weeks of the study indicated that engagement efforts would need to be improved for larger studies. Despite the challenges of collecting wearable data on consecutive days, the data collected provided valuable biological insights, suggesting that the use of questionnaires in conjunction with wearable data may provide a more complete understanding of the menstrual cycle and its impact on daily life. The biological findings should motivate further research into understanding the relationship between the menstrual cycle and objective physiological measurements from sensor devices.

PMID:38470472 | DOI:10.2196/50135

J Med Internet Res. 2024 Mar 12;26:e50741. doi: 10.2196/50741.

ABSTRACT

BACKGROUND: e-Cigarette use, especially by young adults, is at unacceptably high levels and represents a public health risk factor. Digital media are increasingly being used to deliver antivaping campaigns, but little is known about their effectiveness or the dose-response effects of content delivery.

OBJECTIVE: The objectives of this study were to evaluate (1) the effectiveness of a 60-day antivaping social media intervention in changing vaping use intentions and beliefs related to the stimulus content and (2) the dose-response effects of varying levels of exposure to the intervention on vaping outcomes, including anti-industry beliefs, vaping intentions, and other attitudes and beliefs related to vaping.

METHODS: Participants were adults aged 18 to 24 years in the United States. They were recruited into the study through Facebook (Meta Platforms) and Instagram (Meta Platforms), completed a baseline survey, and then randomized to 1 of the 5 conditions: 0 (control), 4, 8, 16, and 32 exposures over a 15-day period between each survey wave. Follow-up data were collected 30 and 60 days after randomization. We conducted stratified analyses of the full sample and in subsamples defined by the baseline vaping status (never, former, and current). Stimulus was delivered through Facebook and Instagram in four 15-second social media videos focused on anti-industry beliefs about vaping. The main outcome measures reported in this study were self-reported exposure to social media intervention content, attitudes and beliefs about vaping, and vaping intentions. We estimated a series of multivariate linear regressions in Stata 17 (StataCorp). To capture the dose-response effect, we assigned each study arm a numerical value corresponding to the number of advertisements (exposures) delivered to participants in each arm and used this number as our focal independent variable. In each model, the predictor was the treatment arm to which each participant was assigned.

RESULTS: The baseline sample consisted of 1491 participants, and the final analysis sample consisted of 57.28% (854/1491) of the participants retained at the 60-day follow-up. We compared the retained participants with those lost to follow-up and found no statistically significant differences across demographic variables. We found a significant effect of the social media treatment on vaping intentions (β=-0.138, 95% CI -0.266 to -0.010; P=.04) and anti-industry beliefs (β=-0.122, 95% CI 0.008-0.237; P=.04) targeted by the intervention content among current vapers but not among the full sample or other strata. We found no significant effects of self-reported exposure to the stimulus.

CONCLUSIONS: Social media interventions are a promising approach to preventing vaping among young adults. More research is needed on how to optimize the dosage of such interventions and the extent to which long-term exposure may affect vaping use over time.

TRIAL REGISTRATION: ClinicalTrials.gov NCT04867668; https://clinicaltrials.gov/study/NCT04867668.

PMID:38470468 | DOI:10.2196/50741