Nevin Manimala

Obes Surg. 2023 Apr 14. doi: 10.1007/s11695-023-06589-0. Online ahead of print.

ABSTRACT

BACKGROUND: Obesity is associated with derangement of cardiac metabolism and the development of subclinical cardiovascular disease. This prospective study examined the impact of bariatric surgery on cardiac function and metabolism.

METHODS: Subjects with obesity underwent cardiac magnetic resonance imaging (CMR) at Massachusetts General Hospital before and after bariatric surgery between 2019 and 2021. The imaging protocol included Cine for global cardiac function assessment and creatine chemical exchange saturation transfer (CEST) CMR for myocardial creatine mapping.

RESULTS: Thirteen subjects were enrolled, and 6 subjects [mean BMI 40.5 ± 2.6] had completed the second CMR (i.e. post-surgery), with a median follow-up of 10 months. The median age was 46.5 years, 67% were female, and 16.67% had diabetes. Bariatric surgery led to significant weight loss, with achieved mean BMI of 31.0 ± 2.0. Additionally, bariatric surgery resulted in significant reduction in left ventricular (LV) mass, LV mass index, and epicardial adipose tissue (EAT) volume. This was accompanied by slight improvement in LV ejection fraction compared to baseline. Following bariatric surgery, there was a significant increase in creatine CEST contrast. Subjects with obesity had significantly lower CEST contrast compared to subjects with normal BMI (n = 10), but this contrast was normalized after the surgery, and statistically similar to non-obese cohort, indicating an improvement in myocardial energetics.

CONCLUSIONS: CEST-CMR has the ability to identify and characterize myocardial metabolism in vivo non-invasively. These results demonstrate that in addition to reducing BMI, bariatric surgery may favorably affect cardiac function and metabolism.

PMID:37058265 | DOI:10.1007/s11695-023-06589-0

Support Care Cancer. 2023 Apr 14;31(5):267. doi: 10.1007/s00520-023-07719-1.

ABSTRACT

PURPOSE: Sarcopenia is prevalent in ovarian cancer and contributes to poor survival. This study is aimed at investigating the association of prognostic nutritional index (PNI) with muscle loss and survival outcomes in patients with ovarian cancer.

METHODS: This retrospective study analyzed 650 patients with ovarian cancer treated with primary debulking surgery and adjuvant platinum-based chemotherapy at a tertiary center from 2010 to 2019. PNI-low was defined as a pretreatment PNI of < 47.2. Skeletal muscle index (SMI) was measured on pre- and posttreatment computed tomography (CT) at L3. The cut-off for the SMI loss associated with all-cause mortality was calculated using maximally selected rank statistics.

RESULTS: The median follow-up was 4.2 years, and 226 deaths (34.8%) were observed. With a median duration of 176 days (interquartile range: 166-187) between CT scans, patients experienced an average decrease in SMI of 1.7% (P < 0.001). The cut-off for SMI loss as a predictor of mortality was – 4.2%. PNI-low was independently associated with SMI loss (odds ratio: 1.97, P = 0.001). On multivariable analysis of all-cause mortality, PNI-low and SMI loss were independently associated with all-cause mortality (hazard ratio: 1.43, P = 0.017; hazard ratio: 2.27, P < 0.001, respectively). Patients with both SMI loss and PNI-low (vs. neither) had triple the risk of all-cause mortality (hazard ratio: 3.10, P < 0.001).

CONCLUSIONS: PNI is a predictor of muscle loss during treatment for ovarian cancer. PNI and muscle loss are additively associated with poor survival. PNI can help clinicians guide multimodal interventions to preserve muscle and optimize survival outcomes.

PMID:37058264 | DOI:10.1007/s00520-023-07719-1

Environ Sci Pollut Res Int. 2023 Apr 14. doi: 10.1007/s11356-023-26873-x. Online ahead of print.

ABSTRACT

The gas sealing capacity of caprock (SCC) is one of the key factors that determine whether aquifer trap can be constructed into underground gas storage (UGS). However, no standard protocol for evaluating SCC of candidate aquifers has been proposed. Based on the core observation, laboratory experiment, and well logging data, the sealing capacity of the target aquifer caprock of Permian mudstone in D5 block of Litan sag, China, is quantitatively evaluated. The important parameters of mineral brittleness, permeability, breakthrough pressure (BP), mechanical brittleness, thickness, and areal extent that affect the SCC are determined. The results of specific tests and data statistics show that the caprock of D5 block is a low permeability rock with a permeability of 10^-4 mD, and the BP of undisturbed rock is greater than 38 MPa. Although the brittle mineral quartz is abundant with an average of 38.38%, the mechanical brittleness is not strong under formation conditions. The direct caprock has a thickness of greater than 50 m, and on the top of it is a high-quality indirect caprock that complements the physical closure. The results of a mathematical evaluation model show that except for the sealing index of sample 2, all the other samples have optimal sealing capacity. The field interference test shows that the optimal sealing capacity of the caprock meets the requirements of the construction of underground gas storage (UGS). The rationality of the comprehensive evaluation model can provide a reference for similar evaluation projects in the future.

PMID:37058239 | DOI:10.1007/s11356-023-26873-x

Eur Geriatr Med. 2023 Apr 14. doi: 10.1007/s41999-023-00778-x. Online ahead of print.

ABSTRACT

PURPOSE: To compare the diagnostic value of relative sit-to-stand muscle power with grip strength or gait speed for identifying a history of recurrent falls and fractures in older adults.

METHODS: Data from an outpatient clinic included anthropometry (height/weight), bone density, 5 times sit-to-stand time (stopwatch and standardized chair), grip strength (hydraulic dynamometer), and gait speed (4 m). Relative sit-to-stand muscle power (W.kg^-1, normalised to body mass) was calculated using a validated equation. Outcomes of falls (past 1 year) and fractures (past 5 years) were self-reported and verified by medical records wherever possible. Binary logistic regression considering for potential confounders (age, sex, BMI, Charlson comorbidity index, femoral neck bone density) and receiver operating characteristics (ROC) curves were used in statistical analysis.

RESULTS: 508 community-dwelling older adults (median age: 78 years, interquartile range: 72, 83, 75.2% women) were included. Compared to greater relative sit-to-stand muscle power (1.62-3.78W.kg^-1 for women; 2.03-3.90W.kg^-1 for men), those with extremely low relative sit-to-stand muscle power were 2.35 (95% CI 1.54, 3.60, p < 0.001) and 2.41 (95% CI 1.25, 4.65, p = 0.009) times more likely to experience recurrent falls and fractures, respectively, in fully adjusted model. Compared to grip strength or gait speed, relative sit-to-stand muscle power showed the highest area under the ROC curve for identifying recurrent falls (AUC: 0.64) and fractures (AUC: 0.62). All tests showed low diagnostic power (AUC: < 0.7).

CONCLUSION: Relative sit-to-stand muscle power performed slightly (but not statistically) better than grip strength or gait speed for identifying a history of recurrent falls and fractures in older adults. However, all tests showed low diagnostic power.

PMID:37058233 | DOI:10.1007/s41999-023-00778-x

Forensic Sci Med Pathol. 2023 Apr 14. doi: 10.1007/s12024-023-00620-7. Online ahead of print.

ABSTRACT

The existing methods for determining adult age from human skeletons are mostly qualitative. However, a shift in quantifying age-related skeletal morphology on a quantitative scale is emerging. This study describes an intuitive variable extraction technique and quantifies skeletal morphology in continuous data to understand their aging pattern. A total of 200 postmortem CT images from the deceased aged 25-99 years (130 males, 70 females) who underwent forensic death investigations were used in the study. The 3D volume of the fourth lumbar vertebral body was segmented, smoothed, and post-processed using the open-source software ITK-SNAP and MeshLab, respectively. To measure the extent of 3D shape deformity due to aging, the Hausdorff distance (HD) analysis was performed. In our context, the maximum Hausdorff distance (maxHD) was chosen as a metric, which was subsequently studied for its correlation with age at death. A strong statistically significant positive correlation (P < 0.001) between maxHD and age at death was observed in both sexes (Spearman’s rho = 0.742, male; Spearman’s rho = 0.729, female). In simple linear regression analyses, the regression equations obtained yielded the standard error of estimates of 12.5 years and 13.1 years for males and females, respectively. Our study demonstrated that age-related vertebral morphology could be described using the HD method. Moreover, it encourages further studies with larger sample sizes and on other population backgrounds to validate the methodology.

PMID:37058209 | DOI:10.1007/s12024-023-00620-7

World J Pediatr. 2023 Apr 14. doi: 10.1007/s12519-023-00720-y. Online ahead of print.

ABSTRACT

BACKGROUND: Medical clowning has been proven effective in reducing pain, anxiety, and stress in many sporadic, usually small-scale studies. Our meta-analysis aims to evaluate the efficiency of medical clowns in reducing pain and anxiety in hospitalized pediatric patients and their parents in different medical fields.

METHODS: A thorough literature search was conducted from different databases, and only randomized controlled trials (RCTs) were included with children aged 0 to 18 years old. A total of 18 studies were included, and statistical analysis was performed on the combined data.

RESULTS: A total of 912 children (14 studies) showed significantly reduced anxiety when procedures were performed with a medical clown compared with the controls (- 0.76 on anxiety score, P < 0.001). Preoperative anxiety was lower in 512 children (nine studies) with clown interventions than in the controls (- 0.78, P < 0.001). The pain scale was completed by 338 participants (six studies), indicating a trend toward reduced pain during procedures performed while the clown was acting compared to controls (- 0.49, P = 0.06). In addition, medical clown significantly (- 0.52, P = 0.001) reduced parental anxiety in 489 participants in ten studies; in six of the ten studies, with a total of 380 participants, medical clown significantly reduced parental preoperative anxiety (P = 0.02).

CONCLUSION: Medical clowns have substantial positive and beneficial effects on reducing stress and anxiety in children and their families in various circumstances in pediatrics.

PMID:37058203 | DOI:10.1007/s12519-023-00720-y

Eur Phys J E Soft Matter. 2023 Apr 14;46(4):29. doi: 10.1140/epje/s10189-023-00288-5.

ABSTRACT

A drop bouncing on a vertically vibrated surface may self-propel forward by standing waves and travels along a fluid interface. This system called walking drop forms a non-quantum wave-particle association at the macroscopic scale. The dynamics of one particle has triggered many investigations and has resulted in spectacular experimental results in the last decade. We investigate numerically the dynamics of an assembly of walkers, i.e., a large number of walking drops evolving on a unbounded fluid interface in the presence of a confining potential acting on the particles. We show that even if the individual trajectories are erratic, the system presents a well-defined ordered internal structure that remains invariant to parameter variations such as the number of drops, the memory time and the bath radius. We rationalize such non-stationary self-organization in terms of the symmetry of the waves and show that oscillatory pair potentials form a wavy collective state of active matter.

PMID:37058179 | DOI:10.1140/epje/s10189-023-00288-5

Med Oncol. 2023 Apr 14;40(5):148. doi: 10.1007/s12032-023-01989-9.

ABSTRACT

The superiority of oral cryotherapy (OC) for prevention of chemotherapy-induced oral mucositis (OM) has been demonstrated in several trials. In clinical settings, cooling is usually initiated prior to the chemotherapy infusion. It then continues during the infusion, and for a period after the infusion has been completed. While the cooling period post-infusion depends on the half-life of the chemotherapeutic drug, there is no consensus on when cooling should be initiated prior to the infusion. The lowest achieved temperature in the oral mucosa is believed to provide the best condition for OM prevention. Given this, it was of interest to investigate when along the course of intraoral cooling this temperature is achieved. In total, 20 healthy volunteers participated in this randomized crossover trial. Each subject attended three separate cooling sessions of 30 min each, with ice chips (IC) and the intraoral cooling device (ICD) set to 8 and 15 °C, respectively. At baseline and following 5, 10, 15, 20 and 30 min of cooling, intraoral temperatures were registered using a thermographic camera. The greatest drop in intraoral temperature was seen after 5 min of cooling with IC, ICD^8°C and ICD^15°C, respectively. A statistically significant difference, corresponding to 1.4 °C, was seen between IC and the ICD^15°C (p < 0.05). The intraoral temperature further declined throughout the 30 min of cooling, showing an additional temperature reduction of 3.1, 2.2, and 1.7 °C for IC, ICD^8°C and ICD^15°C, respectively.

PMID:37058178 | DOI:10.1007/s12032-023-01989-9

Int Urogynecol J. 2023 Apr 14. doi: 10.1007/s00192-023-05498-1. Online ahead of print.

ABSTRACT

INTRODUCTION AND HYPOTHESIS: The puborectal muscle (PRM), one of the female pelvic floor (PF) muscles, can get damaged during vaginal delivery, leading to disorders such as pelvic organ prolapse. Current diagnosis involves ultrasound (US) imaging of the female PF muscles, but functional information is limited. Previously, we developed a method for strain imaging of the PRM from US images in order to obtain functional information. In this article, we hypothesize that strain in the PRM would differ from intact to the avulsed end.

METHODS: We calculated strain in PRMs at maximum contraction, along their muscle fiber direction, from US images of two groups of women, which consisted of women with intact (n₁ = 8) and avulsed PRMs (unilateral) (n₂ = 10). Normalized strain ratios between both ends of the PRM (avulsed or intact) and the mid region were calculated. Subsequently, the difference in ratio between the avulsed and intact PRMs was determined.

RESULTS: We observe from the obtained results that the contraction/strain pattern of intact and undamaged PRMs is different from PRMs with unilateral avulsion. Normalized strain ratios between avulsed and intact PRMs were statistically significant (p = 0.04).

CONCLUSION: In this pilot study, we were able to show that US strain imaging of PRMs can show differences between intact PRMs and PRMs with unilateral avulsion.

PMID:37058159 | DOI:10.1007/s00192-023-05498-1

Inn Med (Heidelb). 2023 Apr 14. doi: 10.1007/s00108-023-01510-4. Online ahead of print.

ABSTRACT

BACKGROUND: The metabolic syndrome is a decisive risk factor for the manifestation of cardiovascular and metabolic diseases. Metabolic syndrome is the term used to describe the joint presence of specific diseases (obesity, hypertension, type 2 diabetes mellitus, disorders of fat metabolism). A classification is made more difficult by inconsistent definition criteria and a missing International Statistical Classification of Diseases and Related Health Problems (ICD) code. There are no known prevalence studies for Germany based on routine data of the statutory health insurance (GKV).

OBJECTIVE: The main aim of the present study was to classify the metabolic syndrome based on routine data of the GKV and to estimate the frequency of diagnosis. In addition, the influence of social factors (school and educational qualifications) was examined for the subgroup of employees with social insurance.

MATERIAL AND METHODS: A retrospective routine data analysis was carried out based on routine administrative data from the AOK Lower Saxony (AOKN). In contrast to the established definitions, which use medical parameters, the risk factors are taken into account via four coded diagnoses according to the ICD-10 classification: 1) obesity (E66.0, E66.8, E66.9), 2) type 2 diabetes mellitus (E11), 3) hypertension (I10) and 4) metabolic disorders (E78). A metabolic syndrome is present if at least two of the four diagnoses are present.

RESULTS: The prevalence of metabolic syndrome in the population of the AOKN in 2019 was 25.7%. The standardized comparison according to the census population of 2011 showed an increase in the frequency of diagnosis (2009: 21.5% and 2019: 24%). The frequency of diagnosis differed according to school and educational qualifications.

CONCLUSION: A classification and analysis of the frequency of the metabolic syndrome based on routine data of the GKV is possible. Between 2009 and 2019 there was a clear increase in the frequency of diagnoses.

PMID:37058154 | DOI:10.1007/s00108-023-01510-4