Nevin Manimala

Front Med (Lausanne). 2023 Aug 21;10:1228833. doi: 10.3389/fmed.2023.1228833. eCollection 2023.

ABSTRACT

BACKGROUND AND OBJECTIVE: Accurate and fast diagnosis of rheumatic diseases affecting the hands is essential for further treatment decisions. Fluorescence optical imaging (FOI) visualizes inflammation-induced impaired microcirculation by increasing signal intensity, resulting in different image features. This analysis aimed to find specific image features in FOI that might be important for accurately diagnosing different rheumatic diseases.

PATIENTS AND METHODS: FOI images of the hands of patients with different types of rheumatic diseases, such as rheumatoid arthritis (RA), osteoarthritis (OA), and connective tissue diseases (CTD), were assessed in a reading of 20 different image features in three phases of the contrast agent dynamics, yielding 60 different features for each patient. The readings were analyzed for mutual differential diagnosis of the three diseases (One-vs-One) and each disease in all data (One-vs-Rest). In the first step, statistical tools and machine-learning-based methods were applied to reveal the importance rankings of the features, that is, to find features that contribute most to the model-based classification. In the second step machine learning with a stepwise increasing number of features was applied, sequentially adding at each step the most crucial remaining feature to extract a minimized subset that yields the highest diagnostic accuracy.

RESULTS: In total, n = 605 FOI of both hands were analyzed (n = 235 with RA, n = 229 with OA, and n = 141 with CTD). All classification problems showed maximum accuracy with a reduced set of image features. For RA-vs.-OA, five features were needed for high accuracy. For RA-vs.-CTD ten, OA-vs.-CTD sixteen, RA-vs.-Rest five, OA-vs.-Rest eleven, and CTD-vs-Rest fifteen, features were needed, respectively. For all problems, the final importance ranking of the features with respect to the contrast agent dynamics was determined.

CONCLUSIONS: With the presented investigations, the set of features in FOI examinations relevant to the differential diagnosis of the selected rheumatic diseases could be remarkably reduced, providing helpful information for the physician.

PMID:37671403 | PMC:PMC10475553 | DOI:10.3389/fmed.2023.1228833

Front Med (Lausanne). 2023 Aug 21;10:1237601. doi: 10.3389/fmed.2023.1237601. eCollection 2023.

ABSTRACT

For decades, unfractionated heparin (hereafter, heparin) has been the primary anticoagulant used for extracorporeal membrane oxygenation (ECMO) support. More recently, however, bivalirudin, a direct thrombin inhibitor, has emerged as an alternative. This systematic review based on PRISMA guidelines, aims to summarize 16 comparative studies and 8 meta-analysis and review articles published from January, 2011 till May, 2023 which directly compares ECMO courses using heparin versus bivalirudin as the anticoagulant. While this comparison is complicated by the lack of a standardized definition of major bleeding or thrombosis, our overall findings suggest there is no statistical difference between heparin and bivalirudin in incidence of bleeding and thrombosis. That said, some studies found a statistical significance favoring bivalirudin in reducing major bleeding, thrombosis, and the need for transfusions. We also offer essential guidance for appropriately selecting an anticoagulant and monitoring its effect in ECMO settings.

PMID:37671395 | PMC:PMC10476497 | DOI:10.3389/fmed.2023.1237601

Int J Popul Data Sci. 2023 Mar 16;4(2):1817. doi: 10.23889/ijpds.v4i2.1817. eCollection 2019.

ABSTRACT

There has been a recent emphasis to establish and codify large-scale or national Trusted Research Environments (TREs) in the United Kingdom, with a view to limit smaller, local TREs. The basis for this argument is that it avoids duplication of infrastructure, information governance, privacy risks, monopolies and will promote innovation, particularly with commercial partners. However, the work around establishing TREs in the UK largely ignores the long-established local TRE landscape in Scotland, and the way in which local TREs can actually improve data quality, solve technical architecture challenges, promote information governance and risk minimisation, and encourage innovation and collaboration (both academic and commercial). This data centre profile focuses on the Grampian Data Safe Haven (DaSH), a secure, virtual healthcare data analysis and storage centre located in Aberdeen, Scotland. DaSH was co-established by the NHS Grampian Health Board and University of Aberdeen to allow for the secure processing and linking of health data for the Grampian and Scottish population when it is not practicable to obtain consent from individual patients. As an established trusted research environment now in its 10^th operating year, DaSH technology ensures healthcare, social care data and other types of sensitive data, routinely collected and used without individual patient consent, are made accessible for both academic research and clinical service evaluation and improvements whilst protecting individuals’ privacy at the local, national and international levels. DaSH has registered almost 600 projects and facilitated over 200 distinct research projects with data hosting, extraction, and novel linkages to completion. Ongoing innovation and collaboration between DaSH and the NHS Grampian Health Board continues to expand researcher access to new types of data and data linkages, introduce new technologies for advanced statistical research methods, and supports interdisciplinary research using population health and social care data for research, clinical and commercial advancements, and real-world practitioner applications. The purpose of this paper is to present DaSH’s data population, operating model, architecture and information technology, governance, legislation and management, privacy-by-design principles and data access, data linkage methods, data sources, noteworthy research outputs, and further developments in order to demonstrate the value of local TREs within the data management and access debate.

PMID:37671386 | PMC:PMC10476148 | DOI:10.23889/ijpds.v4i2.1817

Turk J Phys Med Rehabil. 2022 Aug 12;69(2):216-221. doi: 10.5606/tftrd.2023.10857. eCollection 2023 Jun.

ABSTRACT

OBJECTIVES: The aim of this study was to test the validity of the Turkish version of the Chronic Pain Acceptance Questionnaire (CPAQ)-8.

PATIENTS AND METHODS: This methodological and cross-sectional study was conducted with 80 female patients (mean age: 49.5±10 years; range, 28 to 75 years) diagnosed with fibromyalgia syndrome between January 2020 and December 2021. Participants completed the Turkish version of the CPAQ-8, as well as the Fibromyalgia Impact Questionnaire, Brief Pain Inventory, Hospital Anxiety and Depression Scale, and Tampa Kinesiophobia Scale. Internal consistency, confirmatory factor analysis, and construct validity were examined in the statistical analysis of the data obtained.

RESULTS: The two-factor model created by exploratory factor analysis provided a better fit than the global factor model. Cronbach’s alphas of both subscales of the CPAQ-8 were found to be 0.76 and 0.80; therefore, they provided internal consistency. The CPAQ-8 was found to be significantly correlated with all other scales compared.

CONCLUSION: The Turkish version of the CPAQ-8 is an assessment tool with sufficient validity in assessing pain acceptance levels in fibromyalgia patients experiencing chronic pain. Future studies are needed to evaluate the validity and reliability of the questionnaire in different chronic pain models.

PMID:37671382 | PMC:PMC10475906 | DOI:10.5606/tftrd.2023.10857

Turk J Phys Med Rehabil. 2022 Nov 24;69(2):207-215. doi: 10.5606/tftrd.2023.11054. eCollection 2023 Jun.

ABSTRACT

OBJECTIVES: In this study, we aimed to clarify the impact of a Pilates-based therapeutic exercise on disability, pain, mood, and sleep quality in patients with pregnancy-related lumbopelvic pain (LPP).

PATIENTS AND METHODS: In the single-blinded randomized controlled study conducted between January 2018 and June 2018, 34 pregnant women (mean age: 29.7±6.2 years; range, 18 to 40 years) in the second trimester (week 14-24) with LPP were randomly assigned to a control group and a Pilates group. All patients underwent usual prenatal care. In addition, the selected Pilates exercise was carried out twice a week for 60-min per session for 12 weeks in the Pilates group. The control group was not prescribed an exercise regimen; however, they were not discouraged from exercising. The primary outcome was disability; secondary outcomes were LPP, mood, and sleep quality. Disability [Roland-Morris Disability Questionnaire (RMDQ)], LPP [Visual Analog Scale (VAS)], mood [Hospital Anxiety and Depression Scale, Anxiety (HADS-A) and Depression (HADS-D) subscales], and sleep quality [Pittsburgh Sleep Quality Index (PSQI)] were measured before and after 12 weeks. Adverse effects and adherence were recorded to determine exercise safety and compliance. The intention-to-treat analysis was applied.

RESULTS: The between-group effect sizes were moderate for the RMDQ and VAS scales (d=0.4 and d=0.7, respectively) and small for the HADS-A and HADS-D scales (both d=0.2). The intention-to-treat analysis demonstrated that there was a statistically significant difference in disability, pain, and mood in favor of the Pilates group (p0.05).

CONCLUSION: Adding Pilates to usual prenatal care should be considered a promising treatment option for pregnancy-related LPP.

PMID:37671372 | PMC:PMC10475913 | DOI:10.5606/tftrd.2023.11054

RSC Adv. 2023 Sep 4;13(38):26357-26365. doi: 10.1039/d3ra03200k. eCollection 2023 Sep 4.

ABSTRACT

The solid-state reaction method was utilised to create a down-conversion phosphor in an air environment in CaY₂O₄:Eu³⁺ nanocrystalline material. The calcination temperature was set at 1000 °C, and the sintering temperature was set at 1300 °C. Following annealing, confirmation of the crystallinity quality of the phosphor was accomplished by the use of X-ray diffraction analysis. The particle size was predicted to be 43.113 nm using Scherrer’s formula. To produce down-conversion luminescence spectra, an excitation wavelength of 247 nm was applied with a fluorescence spectrophotometer. The PL got increasingly intense as the concentration of the dopant increased. The maximum intensity was measured at 2.0 mol% of Eu³⁺ ion, which gradually decreased as the concentration increased because of concentration quenching. To analyse spectrophotometric peak determinations, the approach developed by the Commission Internationale de l’Éclairage (CIE) was used. Thermoluminescence (TL) glow curve analysis of the CaY₂O₄:Eu³⁺-doped phosphor manufactured here revealed a wide TL centred at 225 °C, which comprised of so many peaks that may be extracted by the computerised glow curve deconvolution (CGCD) approach using glow-fit software. The associated kinetic parameters were then determined. The prepared phosphor may be useful for application in various display devices upon excitation by 247 nm; the prominent 613 nm peak of the Eu³⁺ ion (⁵D₀ → ⁷F₂) electric dipole transition features a red component. CaY₂O₄:Eu³⁺ phosphors show promise as materials for potential use in phosphor-converted white LEDs in the field of solid-state lighting technology. The linear connection that the TL glow curve has with UV dose provides evidence for its possible use in dosimetry.

PMID:37671341 | PMC:PMC10476512 | DOI:10.1039/d3ra03200k

Internet Interv. 2023 Aug 25;34:100662. doi: 10.1016/j.invent.2023.100662. eCollection 2023 Dec.

ABSTRACT

The COVID-19 pandemic influence mental health in both infected and non-infected populations. In this study we examined if individually tailored internet-based cognitive behavioral therapy (ICBT) could be an effective treatment for psychological symptoms related to the pandemic. Following recruitment we included 76 participants who were randomized to either a treatment group (n = 37) or a waitlist control group (n = 39). The treatment group received 8 modules (out of 16 possible) during 8 weeks with weekly therapist support. We collected data on symptoms of depression, experienced quality of life, anxiety, stress, anger, insomnia, PTSD, and alcohol use before, after the treatment and at one year follow-up. Using multiple regression analysis, group condition was found to be a statistically significant predictor for a decrease, favoring the treatment group, in symptoms of depression, insomnia, and anger with small to moderate effect sizes. The improvements remained at one year follow-up. Group condition did not significantly predict changing symptoms regarding experienced quality of life, anxiety, stress, PTSD and alcohol use. Findings indicate that ICBT is an effective intervention for some psychological symptoms associated with the COVID-19 pandemic. There is a need for further studies on mechanisms of change and on tailored ICBT for problems associated with crises like the pandemic.

PMID:37671335 | PMC:PMC10475474 | DOI:10.1016/j.invent.2023.100662

Cancer Diagn Progn. 2023 Sep 3;3(5):538-542. doi: 10.21873/cdp.10252. eCollection 2023 Sep-Oct.

ABSTRACT

BACKGROUND/AIM: We performed a multicenter retrospective observational study to investigate the impact of immune checkpoint inhibitors (ICIs) on the survival of patients with bone metastases (BMs) from renal cell cancer (RCC).

PATIENTS AND METHODS: A total of 98 patients with metastatic RCC (mRCC) treated with ICIs were retrospectively enrolled. All patients received standard treatments with nivolumab alone or in combination with ipilimumab from December 2015 to March 2022. The primary endpoint was median overall survival (OS).

RESULTS: Forty-three patients (44%) had radiological evidence of BMs. No statistically significant difference in OS was reported between the BM population and the entire population (p=0.254).

CONCLUSION: Our study suggests some degree of ICI activity to treat patients with BMs from RCC, historically associated with a poorer prognosis.

PMID:37671314 | PMC:PMC10475921 | DOI:10.21873/cdp.10252

Cancer Diagn Progn. 2023 Sep 3;3(5):582-589. doi: 10.21873/cdp.10258. eCollection 2023 Sep-Oct.

ABSTRACT

AIM: This study evaluated the relationship between the relative dose intensity (RDI) and the prognosis to assess the optimal duration of adjuvant chemotherapy for pancreatic cancer.

PATIENTS AND METHODS: From 2013 to 2018, 119 patients with pancreatic cancer underwent radical surgery. After excluding five patients who underwent R2 resection, three with stage IV disease, and two with adjuvant chemotherapy other than S-1, 109 cases were evaluated. They were classified into four groups based on the RDI for the total dosage of S-1: group 1: <50%, group 2: 50% to <80%, group 3: 80% to ≤125%, and group 4: >125%.

RESULTS: The number of patients in each group were 48, 20, 30 and 11, with median ages of 74, 73, 66 and 74, respectively. Median estimated glomerular filtration rate was 75, 72, 89 and 77 ml/min/1.73 m², respectively, demonstrating statistically significant differences. The corresponding median and 5-year overall survival rates were: 378 days and 17.9%; 1,011 days and 35.1%; 1,246 days and 41.6%; 1,389 days and 10.6%. Using group 1 as a reference, the adjusted hazard ratio was 0.39 for group 2, 0.36 for group 3, and 0.30 for group 4; all were statistically significant.

CONCLUSION: The higher the RDI of S-1 in adjuvant chemotherapy, the better the overall survival. Therefore, 1 year of adjuvant chemotherapy with S-1 in pancreatic cancer may be preferable to 6 months.

PMID:37671302 | PMC:PMC10475917 | DOI:10.21873/cdp.10258

J Neurol Surg B Skull Base. 2023 Jan 16;84(5):521-529. doi: 10.1055/a-1993-7468. eCollection 2023 Oct.

ABSTRACT

Objectives This study aimed to investigate the morphometric features of the stylomastoid foramen (SMF) and the facial canal in the Turkish population using cone-beam computed tomography (CBCT) retrospectively. Methods The randomly selected 479 patients aged from 8 to 87 years were examined, and a total of 958 CBCT images of the SMF and facial canal (FC) were analyzed. The diameter of the SMF and FC at the mastoid segment and their relation to age, gender, and side were evaluated. Statistical analyses were performed using Kolmogorov-Smirnov, one-way analysis of variance, Student’s t -test, chi-squared test, Tukey’s honestly significant difference, and Fisher-Freeman-Halton exact test. p -Values < 0.05 were accepted as statistically significant at the 95% confidence interval. Results The mean age of the patients was 40.49 ± 19.73 years. The mean diameter of the right SMF was 2.24 ± 0.58 and 2.50 ± 0.63 mm in females and males. The mean diameter of the left SMF was 2.25 ± 0.56 and 2.44 ± 0.62 mm in females and males. The mean diameter of the right FC was 1.60 ± 0.35 and 1.70 ± 0.34 mm in females and males. The mean diameter of left FC was 1.55 ± 0.35 and 1.66 ± 0.33 mm in females and males. A statistically significant difference was found between the age groups in terms of the mean SMF and FC diameter on both sides ( p < 0.05). Conclusion Information obtained from this study regarding the morphometric features of the SMF and thereby FC may assist surgeons in treatment plans and reduce the risk of neurosurgical complications.

PMID:37671299 | PMC:PMC10477010 | DOI:10.1055/a-1993-7468