Nevin Manimala

BMC Pulm Med. 2023 Dec 9;23(1):498. doi: 10.1186/s12890-023-02804-x.

ABSTRACT

BACKGROUND: The associations between neck pain and respiratory dysfunction were clarified in patients with neck pain. There is dearth of evidence on pulmonary dysfunction and diaphragmatic excursion in patients with unilateral cervical radiculopathy (CR). The purpose of this study was to compare the breathing pattern and diaphragmatic excursion in patients with unilateral CR with those in an asymptomatic group.

METHODS: Twenty-five patients with unilateral CR and 25 asymptomatic individuals aged between 30 and 55 participated in this study. Diaphragmatic motion, breathing pattern, active cervical range of motion and kinesiophobia were investigated in both groups by using fluoroscopy, manual assessment of respiratory motion (MARM), cervical range of motion device, and Tampa scale of kinesiophobia. Statistical significance was set at 0.05.

RESULTS: No statistically significant differences were found between the two groups with regard to sex, age and body mass index. The mean excursion of the hemi diaphragm on the involved side (the side of CR) was significantly lower than that on the uninvolved side in patients with unilateral CR with a large effect size. The excursion of the involved hemi diaphragm in patients was reduced compared to the matched hemi diaphragm in the control group. There was no significant difference between the hemi diaphragms excursion in the control group. The results of the MARM variables showed that the volume of breathing and the percentage rib cage motion in normal and deep breathing were significantly different between the two groups, but there was no significant difference in the balance of breathing between the two groups. Additionally, the active cervical range of motion was reduced in these patients in comparison to the control group, and it was less on the involved side than on the uninvolved side.

CONCLUSION: The results of this study revealed a dysfunctional breathing pattern in normal and deep breathing and a unilateral reduction in diaphragmatic excursion on the side of radiculopathy in patients with unilateral CR compared to the control group.

PMID:38071289 | DOI:10.1186/s12890-023-02804-x

BMC Geriatr. 2023 Dec 9;23(1):829. doi: 10.1186/s12877-023-04536-3.

ABSTRACT

BACKGROUND: There are no published longitudinal studies from Africa of people with dementia seen in memory clinics. The aim of this study was to determine the proportions of the different dementia subtypes, rates of cognitive decline, and predictors of survival in patients diagnosed with dementia and seen in a memory clinic.

METHODS: Data were collected retrospectively from clinic records of patients aged ≥ 60 seen in the memory clinic at Groote Schuur Hospital, Cape Town, South Africa over a 10-year period. Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria were used to identify patients with Major Neurocognitive Disorders (dementia). Additional diagnostic criteria were used to determine the specific subtypes of dementia. Linear regression analysis was used to determine crude rates of cognitive decline, expressed as mini-mental state examination (MMSE) points lost per year. Changes in MMSE scores were derived using mixed effects modelling to curvilinear models of cognitive change, with time as the dependent variable. Multivariable cox survival analysis was used to determine factors at baseline that predicted mortality.

RESULTS: Of the 165 patients who met inclusion criteria, 117(70.9%) had Major Neurocognitive Disorder due to Alzheimer’s disease (AD), 24(14.6%) Vascular Neurocognitive Disorder (VND), 6(3.6%) Dementia with Lewy Bodies (DLB), 5(3%) Parkinson disease-associated dementia (PDD), 3(1.8%) fronto-temporal dementia, 4(2.4%) mixed dementia and 6(3.6%) other types of dementia. The average annual decline in MMSE points was 2.2(DLB/PDD), 2.1(AD) and 1.3(VND). Cognitive scores at baseline were significantly lower in patients with 8 compared to 13 years of education and in those with VND compared with AD. Factors associated with shorter survival included age at onset greater than 65 (HR = 1.82, 95% C.I. 1.11, 2.99, p = 0.017), lower baseline MMSE (HR = 1.05, 95% C.I. 1.01, 1.10, p = 0.029), Charlson’s comorbidity scores of 3 to 4 (HR = 1.88, 95% C.I. 1.14, 3.10, p = 0.014), scores of 5 or more (HR = 1.97, 95% C.I. 1.16, 3.34, p = 0.012) and DLB/PDD (HR = 3.07, 95% C.I. 1.50, 6.29, p = 0.002). Being female (HR = 0.59, 95% C.I.0.36, 0.95, p = 0.029) was associated with longer survival.

CONCLUSIONS: Knowledge of dementia subtypes, the rate and factors affecting cognitive decline and survival outcomes will help inform decisions about patient selection for potential future therapies and for planning dementia services in resource-poor settings.

PMID:38071284 | DOI:10.1186/s12877-023-04536-3

J Orthop Surg Res. 2023 Dec 9;18(1):946. doi: 10.1186/s13018-023-04438-5.

ABSTRACT

BACKGROUND: Triangular fibrocartilage complex (TFCC) injury is a frequent soft tissue injury that has been observed to accompany distal radius fractures (DRFs) with concomitant changes in radiologic parameters. The aim of this study was to investigate the relevance of distal radial radiologic parameters associated with DRF and traumatic TFCC injury.

METHODS: A total of 172 patients with distal radius fractures who underwent X-ray, CT, and MRI before undergoing volar locking plate or external splint fixation between October 2021 and December 2022 were included in this study. An analysis of various radiologic parameters and the classification of fracture type and TFCC injuries by CT and MRI was performed. All patients were divided into the TFCC uninjured group and the injured group. The incidence and relevant radiologic parameters were compared.

RESULTS: This study included 76 males and 96 females with a mean age of 56.1 years. Among all patients, 33 (19.2%), 40 (23.2%), and 99 (57.6%) had DRF with A, B, and C fractures, respectively, according to the AO/OTA classification. In patients with fractures, the TFCC was found to be injured in 54.1% (93/172) of patients (type 1A in 21, 1B in 46, 1C in 39, and 1D in 35) but uninjured in 45.9% (79/172). There were significant differences between the TFCC injured and uninjured groups regarding the radius length (p = 0.044) and DRUJ distance (p = 0.040) of radiologic parameters that changed with DRF, although there were no differences between the two groups regarding gender, age, injured side, intra- and extra-articular, radius inclination and palmer tilt angle, or sagittal translation. Within the TFCC injured group, the radius length and DRUJ distance were 4.83 mm and 2.95 mm less or wider than 7.19 mm and 1.83 mm of the uninjured group. Moreover, shorter radius length was related to type lB TFCC injury (p = 0.041). Both radius length (AUC = 0.658) and DRUJ distance (AUC = 0.582) had no convincing predictive value for TFCC injury in DRF.

CONCLUSION: 1B TFCC injury is most common in patients with DRF and concomitant TFCC injury. Both radius length and DRUJ distance have a significant statistical correlation with TFCC injury, and patients with TFCC injury tend to have a shortened radius and wider DRUJ distance, although they have no predictive value for TFCC injury in DRF. In addition, a shorter radius length was related to type lB TFCC injury.

PMID:38071283 | DOI:10.1186/s13018-023-04438-5

Sci Rep. 2023 Dec 9;13(1):21812. doi: 10.1038/s41598-023-49143-9.

ABSTRACT

Bicycles are an eco-friendly mode of transportation, and in the capital city of South Korea, Seoul, efforts are being made to encourage citizens to use bicycles. However, without appropriate safety measures, these efforts can lead to an increase in bicycle-related traffic accidents. To promote bicycle usage while ensuring safety, this study identified various factors that influence bicycle accidents. Data were utilized that had not been properly considered in previous bicycle accident-related studies, including slope and the level of public transportation services. By considering the factors influencing bicycle traffic accidents, various models were constructed, and through comparisons of statistical indicators, the optimal model was selected geographically weighted negative binomial regression. Ultimately, three significant conclusions to ensure bicycle safety were drawn. First, across all areas of Seoul, an increase in road slope leads to a decrease in bicycle-related accidents. Furthermore, for certain Traffic Analysis Zones (TAZs), as the number of local buses (or neighborhood/community buses) increases, the bicycle traffic volume decreases, resulting in a reduction in bicycle accidents. Lastly, for some TAZs, an increase in bicycle lanes to be installed into the roadway was associated with an increase in bicycle accidents.

PMID:38071264 | DOI:10.1038/s41598-023-49143-9

Sci Rep. 2023 Dec 9;13(1):21849. doi: 10.1038/s41598-023-49159-1.

ABSTRACT

Early detection of prostate cancer (PCa) and benign prostatic hyperplasia (BPH) is crucial for maintaining the health and well-being of aging male populations. This study aims to evaluate the performance of transfer learning with convolutional neural networks (CNNs) for efficient classification of PCa and BPH in transrectal ultrasound (TRUS) images. A retrospective experimental design was employed in this study, with 1380 TRUS images for PCa and 1530 for BPH. Seven state-of-the-art deep learning (DL) methods were employed as classifiers with transfer learning applied to popular CNN architectures. Performance indices, including sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), Kappa value, and Hindex (Youden’s index), were used to assess the feasibility and efficacy of the CNN methods. The CNN methods with transfer learning demonstrated a high classification performance for TRUS images, with all accuracy, specificity, sensitivity, PPV, NPV, Kappa, and Hindex values surpassing 0.9400. The optimal accuracy, sensitivity, and specificity reached 0.9987, 0.9980, and 0.9980, respectively, as evaluated using twofold cross-validation. The investigated CNN methods with transfer learning showcased their efficiency and ability for the classification of PCa and BPH in TRUS images. Notably, the EfficientNetV2 with transfer learning displayed a high degree of effectiveness in distinguishing between PCa and BPH, making it a promising tool for future diagnostic applications.

PMID:38071254 | DOI:10.1038/s41598-023-49159-1

Nat Commun. 2023 Dec 9;14(1):8177. doi: 10.1038/s41467-023-44031-2.

ABSTRACT

Counteracting the overactivation of glucocorticoid receptors (GR) is an important therapeutic goal in stress-related psychiatry and beyond. The only clinically approved GR antagonist lacks selectivity and induces unwanted side effects. To complement existing tools of small-molecule-based inhibitors, we present a highly potent, catalytically-driven GR degrader, KH-103, based on proteolysis-targeting chimera technology. This selective degrader enables immediate and reversible GR depletion that is independent of genetic manipulation and circumvents transcriptional adaptations to inhibition. KH-103 achieves passive inhibition, preventing agonistic induction of gene expression, and significantly averts the GR’s genomic effects compared to two currently available inhibitors. Application in primary-neuron cultures revealed the dependency of a glucocorticoid-induced increase in spontaneous calcium activity on GR. Finally, we present a proof of concept for application in vivo. KH-103 opens opportunities for a more lucid interpretation of GR functions with translational potential.

PMID:38071198 | DOI:10.1038/s41467-023-44031-2

Sci Rep. 2023 Dec 9;13(1):21855. doi: 10.1038/s41598-023-49029-w.

ABSTRACT

In this paper, we aim to present a powerful approach for the approximate results of multi-dimensional diffusion problems with time-fractional derivatives. The fractional order is considered in the view of the Caputo fractional derivative. In this analysis, we develop the idea of the Yang homotopy perturbation transform method (YHPTM), which is the combination of the Yang transform (YT) and the homotopy perturbation method (HPM). This robust scheme generates the solution in a series form that converges to the exact results after a few iterations. We show the graphical visuals in two-dimensional and three-dimensional to provide the accuracy of our developed scheme. Furthermore, we compute the graphical error to demonstrate the close-form analytical solution in the comparison of the exact solution. The obtained findings are promising and suitable for the solution of multi-dimensional diffusion problems with time-fractional derivatives. The main advantage is that our developed scheme does not require assumptions or restrictions on variables that ruin the actual problem. This scheme plays a significant role in finding the solution and overcoming the restriction of variables that may cause difficulty in modeling the problem.

PMID:38071195 | DOI:10.1038/s41598-023-49029-w

Dig Liver Dis. 2023 Dec 8:S1590-8658(23)01071-X. doi: 10.1016/j.dld.2023.11.030. Online ahead of print.

ABSTRACT

BACKGROUND AND AIMS: Despite its growing popularity, endoscopic submucosal dissection (ESD) for colorectal neoplasms is still technically challenging. The factors contributing to the failure of ESD are not yet comprehensively elucidated. Therefore, this systematic review was conducted to explore the potential risk factors associated with unsuccessful colorectal ESD.

METHODS: A comprehensive search of Medline and Embase databases was conducted to identify relevant publications from inception until March 14, 2023. Unsuccessful ESD was defined as cases involving incomplete resection or the occurrence of adverse events, such as perforation and delayed bleeding.

RESULTS: Among the 2067 citations initially identified, a total of 23 cohort studies and 16 case-control studies met the inclusion criteria. Following meta-analyses, several significant risk factors for incomplete resection were identified, including lesion diameter ≥40 or 50 mm, right-side colonic location, deeper submucosal invasion, and severe fibrosis. Similarly, lesion diameter ≥40 or 50 mm and severe fibrosis emerged as risk factors for perforation. However, no individual factor was found to be statistically associated with delayed bleeding.

CONCLUSIONS: This meta-analysis identified risk factors correlated with incomplete resection and adverse events following ESD. The findings provide valuable insights that can guide clinical decision-making, aiding gastroenterologists in accurately identifying high-risk individuals.

PMID:38071178 | DOI:10.1016/j.dld.2023.11.030

Endeavour. 2023 Dec 8:100902. doi: 10.1016/j.endeavour.2023.100902. Online ahead of print.

ABSTRACT

Although much scholarship on nineteenth and twentieth century mathematics has focused on processes of professionalization, historical mathematicians themselves rarely experienced their lives as neatly divisible into the professional and the private. Taking marriage as a focal point, this introduction brings the fruitful historiography of gender, collaborative couples, and domesticity in science into a broader conversation with the history of mathematics. By historicizing marriage and its relationship to mathematical careers, we lay the groundwork for the special issue which uncovers the myriad ways in which spousal collaboration and support have been central to mathematical work.

PMID:38071174 | DOI:10.1016/j.endeavour.2023.100902

Ophthalmic Physiol Opt. 2023 Dec 9. doi: 10.1111/opo.13260. Online ahead of print.

ABSTRACT

PURPOSE: There is uncertainty about the effect of increased neonatal protein intake on neurodevelopmental outcomes following preterm birth. The aim of this study was to assess the effect of a change in neonatal nutrition protocol at a major tertiary neonatal intensive care unit intended to increase protein intake on ophthalmic and visual development in school-age children born very preterm.

METHODS: The study cohort comprised children (n = 128) with birthweight <1500 g or gestational age < 30 weeks born at Auckland City Hospital before (OldPro group, n = 55) and after (NewPro group, n = 73) a reformulation of parenteral nutrition that resulted in increased total protein intake during the first postnatal week and decreased carbohydrate, total parenteral fluid and sodium intake. Clinical and psychophysical vision assessments were completed at 7 years’ corrected age, including visual acuity, global motion perception (a measure of dorsal stream function), stereoacuity, ocular motility and ocular health. Composite measures of favourable overall visual, binocular and functional visual outcomes along with individual vision measures were compared between the groups using logistic and linear regression models.

RESULTS: Favourable overall visual outcome did not differ between the two groups. However, global motion perception was better in the NewPro group (p = 0.04), whereas the OldPro group were more likely to have favourable binocular visual outcomes (60% vs. 36%, p = 0.02) and passing stereoacuity (p = 0.02).

CONCLUSIONS: These results indicate subtle but complex associations between early neonatal nutrition after very preterm birth and visual development at school age.

PMID:38069619 | DOI:10.1111/opo.13260