Nevin Manimala

J Matern Fetal Neonatal Med. 2022 Nov 17:1-4. doi: 10.1080/14767058.2022.2145878. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the association between serum folate levels during pregnancy and prenatal depression and the extent to which obesity may modify this relationship.

METHODS: This secondary data analysis leveraged data from a previous study of pregnant Kaiser Permanente Northern California participants who completed a survey and provided a serum sample between 2011 and 2013. Serum folate was assessed using the Center for Disease Control’s Total Folate Serum/Whole Blood Microbiological Assay Method. A score of 15 or greater on the Center for Epidemiologic Studies Depression Scale was defined as prenatal depression. We used Poisson regression to estimate risk of prenatal depression given prenatal serum folate status (low/medium tertiles vs. high tertile) in the full sample and in subsamples of women with pre-pregnancy body mass index in the (a) normal range and (b) overweight/obese range.

RESULTS: Of the sample, 13% had prenatal depression. Combined low/medium folate tertiles was associated with prenatal depression (adjusted relative risk [aRR] = 1.97, 95% confidence interval [CI]: 0.93-4.18), although results did not reach statistical significance. This relationship was stronger among women with overweight/obesity than women with normal weight (aRR: 2.61, 95% CI: 1.01-6.71 and aRR: 1.50, 95% CI: 0.34-6.66, respectively).

CONCLUSION: Results suggest an association between lower pregnancy folate levels and prenatal depression that may be stronger among women with overweight or obesity. Future studies need to clarify the temporal sequence of these associations.

PMID:36396611 | DOI:10.1080/14767058.2022.2145878

Oral Surg Oral Med Oral Pathol Oral Radiol. 2022 Sep 8:S2212-4403(22)01121-X. doi: 10.1016/j.oooo.2022.08.013. Online ahead of print.

ABSTRACT

OBJECTIVE: The present study was conducted to explore the allele frequencies of MICA gene Exon-5 transmembrane and to measure the circulatory MICA levels in various histologic grades of patients with oral submucous fibrosis (OSF) compared to healthy individuals.

STUDY DESIGN: We enrolled a total of 595 patients for this cross-sectional study and divided them into 2 groups: healthy controls (n = 320) and patients with OSF (n = 275). Further, patients with OSF were subdivided based on their histologic gradings. The genomic DNA was extracted followed by a polymerase chain reaction and genotyping using the ABI Prism DNA Sequencer (ThermoFisher Scientific, Inc., Waltham, MA, USA).

RESULTS: Our study showed that the A5 allele of the MICA gene in the Exon-5 region conferred significant risk for patients with OSF. With reference to the histologic gradings of OSF, we found that the MICA gene conferred statistically significant risk among patients with grade III OSF. On the other hand, the A8 allele of MICA gene in the Exon-5 region conferred significant protection among the overall OSF cohort and in the grade III of histologic grade. Finally, the circulatory human MICA levels were found to have a stepwise increase from grade I toward grade III in patients with OSF.

CONCLUSION: Our results suggested that the A5 allele in MICA might confer risk for the progression of OSF among the South Indian ethnic population.

PMID:36396592 | DOI:10.1016/j.oooo.2022.08.013

Oral Surg Oral Med Oral Pathol Oral Radiol. 2022 Oct 21:S2212-4403(22)01180-4. doi: 10.1016/j.oooo.2022.10.004. Online ahead of print.

ABSTRACT

OBJECTIVE: The aim of this study was to measure the volume and visually assess 3-dimensional (3D) virtual models of pulp cavities obtained through semiautomatic segmentation on images from 6 cone beam computed tomography (CBCT) units compared with the reference standard of micro-CT.

STUDY DESIGN: Fifteen mandibular premolar teeth were scanned with 6 CBCT units: Prexion 3D Elite, i-CAT Next Generation, NewTom 5G, Cranex 3D, 3Shape X1, and Orthophos SL 3D, using the smallest available field of view and highest resolution settings. Pulp cavity volumes were quantitatively assessed by 2 calibrated examiners. The volumes from each CBCT unit were compared with micro-CT. Qualitative assessment of the 3D reconstructions was also performed. Repeated-measures analysis of variance and the Friedman test compared the CBCT reconstructions to micro-CT. Intra- and interexaminer agreements were calculated with the intraclass correlation coefficient and kappa statistic.

RESULTS: The CBCT-based volumes were all significantly larger than micro-CT (P ≤ .0061). Prexion, X1, and Orthophos provided the segmentations that most closely resembled the reference standard. Intra- and interexaminer agreements ranged from good to excellent for quantitative measurements. Interexaminer agreement for qualitative evaluation was substantial.

CONCLUSIONS: Semiautomatic segmentation of CBCT images is a feasible method to produce virtual 3D models of the pulp cavity. Prexion, X1, and Orthophos were the CBCT units that resulted in 3D reconstructions most similar to the reference standard.

PMID:36396589 | DOI:10.1016/j.oooo.2022.10.004

Acad Radiol. 2022 Nov 14:S1076-6332(22)00574-8. doi: 10.1016/j.acra.2022.10.018. Online ahead of print.

ABSTRACT

OBJECTIVES: Interscan reproducibility of coronary artery calcium (CAC) scoring can be improved by using a smaller slice thickness but at the cost of higher image noise. This study aimed to investigate the feasibility of using densely connected convolutional network (DenseNet) to reduce the image noise in CAC scans reconstructed with slice thickness < 3 mm for improving coronary calcification detection in CT.

METHODS: Phantom data acquired with QRM and CIRS phantoms were used for model training and testing, where the DenseNet model adopted in this work was a convolutional neural network (CNN) designed for super resolution recovery. After phantom study, the proposed method was evaluated in terms of its ability to improve calcification detection using patient data. The CNN input images (IMG_input) were CAC scans reconstructed with 0.5-, 1.0- and 1.5-mm slice thickness, while CNN label images were CAC scans reconstructed with 3-mm slice thickness (IMG^3mm). Region of interest (ROI) analysis was carried out on IMG^3mm, IMG_input and CNN output images (IMG_output). Two-sample t test was used to compare the difference in Hounsfield Unit (HU) values within ROI between IMG^3mm and IMG_output.

RESULTS: For the calcifications in QRM phantoms, no statistically significant difference was found when comparing the HU values of 400- and 800-HA calcifications identified on IMG^3mm to those on IMG_output with slice thickness of 0.5, 1.0 or 1.5 mm. On the other hand, statistically significant difference was found when comparing the HU values of 200-HA calcifications identified on IMG^3mm to those on IMG_output with a slice thickness of 0.5 and 1.0 mm. Meanwhile, no statistically significant difference was found when comparing the HU values of 200-HA calcifications identified on IMG^3mm to those on IMG_output with a slice thickness of 1.5 mm. As for the rod inserts in CIRS phantoms simulating 9 different tissue types in human body, there was no statistically significant difference between IMG^3mm and IMG_output with slice thickness of 1.5 mm, and all the p values were larger than 0.10. With regards to patient study, more calcification pixels were detected on IMG_output with a slice thickness of 1.5 mm than on IMG^3mm, so calcifications were more clear on the denoised images.

CONCLUSION: According to our results, the CNN-based denoising method could reduce statistical noise in IMG_input with a slice thickness of 1.5 mm without causing significant texture change or variation in HU values. The proposed method could improve cardiovascular risk prediction by detecting small and soft calcifications that are barely identified on 3-mm slice images used in conventional CAC scans.

PMID:36396585 | DOI:10.1016/j.acra.2022.10.018

Evol Comput. 2022 Nov 10:1-35. doi: 10.1162/evco_a_00317. Online ahead of print.

ABSTRACT

Reproducibility of experiments is a complex task in stochastic methods such as evolutionary algorithms or metaheuristics in general. Many works from the literature give general guidelines to favor reproducibility. However, none of them provide both a practical set of steps and also software tools to help on this process. In this paper, we propose a practical methodology to favor reproducibility in optimization problems tackled with stochastic methods. This methodology is divided into three main steps, where the researcher is assisted by software tools which implement state-of-theart techniques related to this process. The methodology has been applied to study the Double Row Facility Layout Problem, where we propose a new algorithm able to obtain better results than the state-of-the-art methods. To this aim, we have also replicated the previous methods in order to complete the study with a new set of larger instances. All the produced artifacts related to the methodology and the study of the target problem are available in Zenodo.

PMID:36395509 | DOI:10.1162/evco_a_00317

Vascular. 2022 Nov 17:17085381221140621. doi: 10.1177/17085381221140621. Online ahead of print.

ABSTRACT

OBJECTIVES: The normalisation of Achilles tendon thickness (ATT) to anthropometric parameters may increase the diagnostic efficiency of the assessment of ATT. The aim of this study was to compare the diagnostic value of AT dimensions depending on their normalization to body surface area (BSA) in patients with asymptomatic peripheral arterial disease (PAD).

METHODS: All patients underwent duplex scanning of the carotid arteries and the lower limb arteries. Asymptomatic PAD was defined as the presence of ≥50% stenosis in the carotid and/or lower limb arteries. ATT was measured using a longitudinal scan, width (ATW) and cross-sectional area (AT CSA), which was determined during a cross-sectional scan.

RESULTS: The study included 369 patients, among whom asymptomatic PAD was detected in 18 (4.88%) patients. Only the ATT demonstrated diagnostic value for asymptomatic PAD. After normalizing the size of the AT to the BSA, the diagnostic performance of ATT, ATW and AT CSA became statistically significant. Among the studied parameters, only an increase in ATT/BSA >0.29 cm/m² was associated with a significant increase in the odds ratio (OR) of asymptomatic PAD by 4.11 times (95% CI 1.08-15.7; p = .038) after adjustments.

CONCLUSION: An increase in ATT/BSA >0.29 cm/m² predicted the presence of asymptomatic PAD with a sensitivity of 61.1% and a specificity of 77.9%. ATT/BSA values of less than 0.29 cm/m² made it possible to exclude asymptomatic PAD with a probability of 97.5%. An increase in ATT/BSA >0.29 cm/m² was associated with a 4.11-fold increase in the OR of asymptomatic PAD (95% CI 1.08-15.7).

PMID:36395485 | DOI:10.1177/17085381221140621

Am J Surg Pathol. 2022 Nov 2. doi: 10.1097/PAS.0000000000001991. Online ahead of print.

ABSTRACT

To compare the diagnostic accuracy of core needle biopsies (CNBs) and surgical excisional biopsies (SEBs), samples of lymphoid proliferation from a single institution from 2013 to 2017 (N=476) were divided into groups of CNB (N=218) and SEB (N=258). The diagnostic accuracy of these samples was evaluated as a percentage of conclusive diagnosis, according to the World Health Organization Classification of Tumours of Haematopoietic and Lymphoid Tissues. The contribution of clinical data, the assessment of sample adequacy by a pathologist during the procedure, the number and size of fragments, the needle gauge, the ancillary tests, and the type of lymphoid proliferation were also examined. The diagnostic accuracy of SEB was 97.3% and CNB 91.3% (P=0.010). Additional factors considered essential for establishing the final diagnosis in some cases were: clinical information (20.6% CNB, 7.4% SEB; P<0.001); immunohistochemistry (96.3% CNB, 91.5% SEB; P=0.024); flow cytometry (12% CNB, 6.8% SEB; P=0.165); and other complementary tests (8.2% CNB, 17.3% SEB; P=0.058). Factors that did not influence performance were the evaluation of sample adequacy during the procedure, the number and size of fragments, and the needle gauge. Increased percentage of nondiagnostic CNB was observed in T-cell lymphomas (30%), followed by classic Hodgkin lymphoma (10.6%). The main limitation of CNB was the evaluation of morphologically heterogenous diseases. CNB is useful and safe in lymphoma diagnosis provided it is carried out by a team of experienced professionals. Having an interventional radiology team engaged with pathology is an essential component to achieve adequate rates of specific diagnoses in CNB specimens.

PMID:36395467 | DOI:10.1097/PAS.0000000000001991

Am J Dermatopathol. 2022 Dec 1;44(12):879-885. doi: 10.1097/DAD.0000000000002321.

ABSTRACT

Patients submitted to radiotherapy for tinea capitis in childhood have an increased incidence of scalp basal cell carcinomas (BCCs) but also of other neoplasms, namely, follicular tumors. In a cohort of such patients, we also found a high incidence of infundibulocystic BCCs, an otherwise rare variant. We thus hypothesized that postradiotherapy BCCs could be more prone to display follicular differentiation. We compared the histological and immunohistochemical features of postradiotherapy BCCs [both conventional (16 cases) and infundibulocystic (16 cases)] with those of BCCs arising in sun-exposed areas (16 cases), using markers of follicular differentiation (PHLDA-1, CK15, CD34, β-catenin, and calretinin). Postradiotherapy BCCs showed slightly higher tendency for infundibular and/or trichilemmal differentiation than BCCs from sun-exposed areas (37.5% vs. 18.8%), but this difference was not statistically significant. Nevertheless, infundibulocystic BCCs showed more frequent expression of PHLDA-1 and stronger cytoplasmic expression of CK15 compared with the other lesions. In addition, CD34 highlighted a characteristic meshwork of stromal cells surrounding the epithelial component in all infundibulocystic BCCs, in contrast to the other postradiotherapy BCCs and UV-related BCCs, in which 78.1% were negative or only focally positive. In conclusion, our study suggests a tendency for more frequent follicular differentiation in postradiotherapy BCCs compared with BCCs from sun-exposed areas. In addition, the immunohistochemical study confirms previous data from the literature regarding infundibulocystic BCCs (higher CK15 and PHLDA-1 expression) and shows a distinctive stromal positivity for CD34 that has not been previously acknowledged in these tumors.

PMID:36395444 | DOI:10.1097/DAD.0000000000002321

Pancreas. 2022 Aug 1;51(7):723-732. doi: 10.1097/MPA.0000000000002113.

ABSTRACT

OBJECTIVES: Chronic pancreatitis (CP) is a chronic fibroinflammatory condition of the pancreas difficult to diagnose in early stages. Novel biomarkers useful to facilitate early diagnosis or treatment responses may be found in biofluids. Although saliva can be easily and noninvasively collected from patients, useful salivary biomarkers from CP patients have not yet been identified.

METHODS: Here, we analyzed the proteome by quantitative proteomics, cytokine/chemokine levels by Luminex analysis, prostaglandin E2 (PGE2) levels by a mass spectrometry-based assay, and bacterial species diversity by 16S ribosomal ribonucleic acid sequencing in saliva samples from confirmed CP patients and healthy controls.

RESULTS: Our results indicate the presence of various differentially expressed proteins, cytokines/chemokines, and a loss of oral bacterial diversity in the saliva of CP patients. The PGE2 levels trend toward elevation in CP patients. Area under the receiver operating characteristic curve models for proteomic, cytokine, and PGE2 assays ranged from 0.59 to 0.90.

CONCLUSIONS: Collectively, our studies identify a range of putative CP biomarkers and alterations in human saliva requiring further validation. The biomarker discovery approaches we used might lead to identification of biomarkers useful for CP diagnosis and monitoring.

PMID:36395395 | DOI:10.1097/MPA.0000000000002113

J Athl Train. 2022 Nov 17. doi: 10.4085/1062-6050-0111.22. Online ahead of print.

ABSTRACT

CONTEXT: There is limited evidence regarding the assessment of single-item patient-reported outcomes when patients are medically cleared to return-to-sport following a lateral ankle sprain (LAS) injury.

OBJECTIVE: To evaluate self-report of improvement in health status, pain, function, and disability at return-to-sport following a LAS.

DESIGN: Descriptive study.

SETTING: Sixty-nine athletic training facilities across 24 states.

PATIENTS OR OTHER PARTICIPANTS: Six hundred and thirty-seven patients (male=53.2%) were included in our final analysis. Patients were diagnosed with a LAS, restricted from sport following injury, and subsequently medically cleared to return-to-sport within 60 days were included.

MAIN OUTCOME MEASURES: Descriptive statistics were used to summarize scores for health status (Global Rating of Change), pain (Numeric Pain Rating Scale), function (Global Rating of Function), and disability (Global Rating of Disability). Mann-Whitney U Tests were used to compare score differences between sexes. A Kaplan-Meier analysis was performed to provide a visual depiction of sex differences in time to return-to-sport.

RESULTS: Most patients sustained a LAS injury while participating in basketball, football, or soccer and cleared to return-to-sport 8 days following injury. Over two-thirds of patients reported a meaningful improvement in health status between time of injury and return-to-sport. However, many reported some level of deficits related to pain (65.1%), function (86.2%), and disability (35.8%) at return-to-sport. No differences were noted between males and females for pain (p=.90), function (p=.68), change (p=.45), or disability (p=.21) at return-to-sport. Males, however, returned to sport slightly sooner than females (p=.025).

CONCLUSIONS: Despite self-perceived improvements in health status from time of injury, patients typically return-to-sport with deficits in pain, function, and disability following a LAS. Patients may be returning to unrestricted sport participation before they feel their bodies have fully recovered from the injury.

LEVEL OF EVIDENCE: Level III; retrospective cohort study.

PMID:36395375 | DOI:10.4085/1062-6050-0111.22