Nevin Manimala

Zh Nevrol Psikhiatr Im S S Korsakova. 2022;122(9):104-109. doi: 10.17116/jnevro2022122091104.

ABSTRACT

OBJECTIVE: To study the cerebral hemodynamics and executive functioning in patients with alcohol use disorders.

MATERIAL AND METHODS: We studied 58 patients with alcohol use disorders aged 30 to 55 years and 40 healthy controls. Rheoencephalography was used to detect cerebrovascular changes. Executive functioning was assessed using the Go-No-Go, Corsi, and Color Stroop tests.

RESULTS: Patients with alcohol use disorders have higher values of the tone of resistive vessels and medium – caliber arteries, as well as lower indicators of volumetric pulse blood filling and elastic properties of the main arteries in both right and left leads compared with the controls (p≤0.003). Patients with alcohol dependence had lower rates in all studied cognitive tests compared to the norm (p≤0.011). We also found statistically significant correlations between the studied parameters in patients with alcohol use disorders: a decrease in volumetric pulse blood filling correlated with impaired psychomotor response in the Go-No-Go task (errors on the Go signal) (rs=-0.36; p=0.048), as well as cognitive flexibility in the Stroop test (rs=-0.40; p=0.024).

CONCLUSION: Disturbances of the psychomotor reaction and cognitive flexibility in alcohol dependence are due to the regional changes (decrease) in cerebral blood flow, as well as to a decrease in the elasticity of the wall of cerebral vessels.

PMID:36168694 | DOI:10.17116/jnevro2022122091104

ACS Nano. 2022 Sep 27. doi: 10.1021/acsnano.2c04406. Online ahead of print.

ABSTRACT

The scalable production and dispersion of 2D materials, like graphene, is critical to enable their use in commercial applications. While liquid exfoliation is commonly used, solvents such as N-methyl-pyrrolidone (NMP) are toxic and difficult to scale up. However, the search for alternative solvents is hindered by the intimidating size of the chemical space. Here, we present a computational pipeline informing the identification of effective exfoliation agents. Classical molecular dynamics simulations provide statistical sampling of interactions, enabling the identification of key molecular descriptors for a successful solvent. The statistically representative configurations from these simulations, studied with quantum mechanical calculations, allow us to gain insights onto the chemophysical interactions at the surface-solvent interface. As an exemplar, through this pipeline we identify a potential graphene exfoliation agent 2-pyrrolidone and experimentally demonstrate it to be as effective as NMP. Our workflow can be generalized to any 2D material and solvent system, enabling the screening of a wide range of compounds and solvents to identify safer and cheaper means of producing dispersions.

PMID:36166830 | DOI:10.1021/acsnano.2c04406

J Neuroophthalmol. 2022 Jun 14. doi: 10.1097/WNO.0000000000001625. Online ahead of print.

ABSTRACT

BACKGROUND: Nonarteritic anterior ischemic optic neuropathy (NAION) has been reported to occur after cataract surgery. It is not clearly established whether cataract surgery increases the risk of NAION over baseline.

EVIDENCE ACQUISITION: Medline, PubMed, Embase, and Cochrane Central registers were systematically searched for eligible studies reporting on postcataract surgery NAION (psNAION) within 1 year. All peer-reviewed publications with events n ≥ 10 were included. Pooled incidence and odds/hazard ratios and 95% confidence intervals (CIs) were extracted and calculated using random effect models for early and delayed psNAION. Time to event data were pooled for temporal analysis of psNAION events within the first year. This systematic review was registered (PROSPERO CRD42021274383).

RESULTS: Nine articles met the selection criteria with five studies suitable for meta-analysis. A total of 320 psNAION cases, 1,307 spontaneous NAION (sNAION) cases, 1,587,691 cataract surgeries, and 1,538,897 noncataract surgery controls were included. Pooling of 63,823 cataract surgeries and 161,643 controls showed a hazard ratio of 4.6 (95% CI 2.7-7.8) of psNAION within 1 year of surgery. Pooled unadjusted incidence of psNAION within 2 months was 99.92 (95% CI 38.64-161.19) per 100,000/year, psNAION within 1 year was 32.36 (95% CI 9.38-55.34) per 100,000/year, and sNAION was 8.87 (95% CI 2.12-15.62) per 100,000/year. psNAION cases were older by a mean of 7.6 years; otherwise, pooled odds ratios for baseline risk factors in psNAION vs. sNAION cases were not statistically significant. psNAION within the first year peaked within 72 hrs and at 6 weeks after the surgery with 73% of cases occurring within 6 months.

CONCLUSION: The risk of NAION after cataract surgery is four times greater within the first year and usually occurs within 6 months. However, the absolute risk remains low at 1 in 1,000-3,100 surgeries and is unlikely to warrant extra mention for consenting.

PMID:36166807 | DOI:10.1097/WNO.0000000000001625

J Neuroophthalmol. 2022 Jun 14. doi: 10.1097/WNO.0000000000001630. Online ahead of print.

ABSTRACT

BACKGROUND: To determine whether patients with biopsy-confirmed optic nerve glioma differ in clinical features and outcomes from those diagnosed by neuroradiologic imaging alone.

METHODS: Retrospective comparative analysis. Pilocytic astrocytomas (PAs) and gliomas of the optic nerve were identified through ICD-O codes in the Surveillance, Epidemiology, and End Results (SEER) cancer registry from 1975 through 2017. Demographics, clinical features, and outcomes were compared according to the method of diagnosis (biopsy-confirmed and radiologic only) and by age (birth through 19 years and 20 years of age and older). Differences in proportions were tested with the chi-square test. Associations with tumor-related death were evaluated with logistic regression. Statistical significance: α < 0.01.

RESULTS: Over 42 years, 313 PAs and 720 gliomas of the optic nerve were identified. The young age distributions were similar between the 2 groups. PAs were biopsied more often than gliomas (54% vs 13.2% [P < 0.001]). Tumor-attributable death occurred more often among PAs and gliomas that were biopsied than those that were not (7.1% vs 0.7% [P < 0.01]; 7.4% vs 1.1% [P < 0.01], respectively). Roughly 15% of both PAs and gliomas were diagnosed in persons 20 years and older.

CONCLUSIONS: Biopsy-confirmed cases of PA and glioma of the optic nerve were associated with more therapeutic interventions and worse outcomes compared with patients who were diagnosed radiologically. Clinical variables relevant to clinical decision-making not captured by SEER likely explain the inability to meaningfully interpret outcome from the registry database. Cancer registries should avoid coding specific histopathologic diagnoses when tissue is not obtained.

PMID:36166806 | DOI:10.1097/WNO.0000000000001630

J Neuroophthalmol. 2022 Jun 14. doi: 10.1097/WNO.0000000000001627. Online ahead of print.

NO ABSTRACT

PMID:36166805 | DOI:10.1097/WNO.0000000000001627

J Neuroophthalmol. 2022 May 24. doi: 10.1097/WNO.0000000000001628. Online ahead of print.

NO ABSTRACT

PMID:36166804 | DOI:10.1097/WNO.0000000000001628

Hum Reprod. 2022 Sep 27:deac211. doi: 10.1093/humrep/deac211. Online ahead of print.

ABSTRACT

STUDY QUESTION: Is the health of singletons born after frozen embryo transfer (FET) comparable to that of singletons born after fresh embryo transfer (ET) until early adulthood?

SUMMARY ANSWER: The health of singletons born after FET does not differ from that of singletons born after fresh ET.

WHAT IS KNOWN ALREADY: The differences in perinatal outcomes of children born after FET and fresh ET are well known. FET is associated with an increased risk of large-for-gestational-age but diminished risks of preterm birth (PTB), small-for-gestational-age and decreased perinatal mortality compared to fresh ET. However, knowledge on the long-term health after FET is scarce.

STUDY DESIGN, SIZE, DURATION: This retrospective register-based cohort study compares singletons born after FET (n = 1825) between the years 1995 and 2006 to those born after fresh ET (n = 2933) and natural conception (NC, n = 31 136) with a mean follow-up time of 18-20 years.

PARTICIPANTS/MATERIALS, SETTING, METHODS: Singletons born after FET were compared to those born after fresh ET and NC regarding the frequencies of diagnoses in the main ICD-10 chapters (International Statistical Classification of Diseases and Related Health Problems, 10th revision), the number of outpatient visits and hospital admissions, and mortality. Adjustments were made for PTB, maternal age, parity, socioeconomic status based on mother’s occupation and offspring sex. The study combines data from the Finnish Medical Birth Register, the Finnish Care Register for Health Care (CRHC) and the Cause-of-Death Register at Statistics Finland. The Student’s T-test was used for continuous variables, and the Chi-square test was used for categorical variables. Cox regression was used to estimate crude and adjusted hazard ratios (HRs and aHRs, respectively). A general linear model was used to compare the means of outpatient visits, hospital admissions and lengths of hospital stays per person.

MAIN RESULTS AND THE ROLE OF CHANCE: No significant differences between the FET and fresh ET groups were found in the frequency of diagnoses in any of the ICD-10 chapters or in the parameters describing the need for hospital care. However, compared to the NC group, higher proportions in the FET group had outpatient visits in the hospital (93.5% vs 92.2%, aHR 1.23, 95% CI 1.17, 1.30) or hospital admissions (48% vs 46.5%, aHR 1.28, 95% CI 1.19, 1.37). Compared to the NC group, the FET group had elevated adjusted risks of diagnoses of infectious and parasitic diseases (aHR 1.24; 95% CI 1.11, 1.38), neoplasms (aHR 1.68; 95% CI 1.48, 1.91), diseases of the eye and adnexa, the ear or mastoid process (aHR 1.11; 95% CI 1.01, 1.21), the respiratory system (aHR 1.15; 95% CI 1.06, 1.23), the digestive system (aHR 1.17; 95% CI 1.05, 1.32), the skin or subcutaneous tissue (aHR 1.28; 95% CI 1.14, 1.43) and the genitourinary system (aHR 1.27; 95% CI 1.11, 1.45), as well as congenital malformations or chromosomal abnormalities (aHR 1.31; 95% CI 1.14, 1.50) and symptoms, signs or abnormal clinical or laboratory findings (aHR 1.25, 95% CI 1.16, 1.34).

LIMITATIONS, REASONS FOR CAUTION: Only hospital-based inpatient and outpatient care is covered by the CRHC register, excluding milder cases diagnosed elsewhere. We were not able to study the effect of ART treatments and subfertility separately in our setting. In addition, although our cohort is reasonably sized, even larger cohorts would be needed to reliably study rare outcomes, such as cancer.

WIDER IMPLICATIONS OF THE FINDINGS: For many ICD-10 chapters, we present the first published data on the long-term outcome of singletons born after FET. The results on FET versus fresh ET are reassuring, whereas the results on FET versus NC warrant further investigation.

STUDY FUNDING/COMPETING INTEREST(S): Finnish government research funding was obtained for this study. Funding was also obtained from the Finnish Medical Society Duodecim, the Päivikki and Sakari Sohlberg Foundation, Orion Research Foundation, Finnish Society of Obstetrics and Gynaecology (research grants to A.M.T.) and Finnish government research funding. The funding sources were not involved in the planning or execution of the study. The authors have no competing interests to declare.

TRIAL REGISTRATION NUMBER: N/A.

PMID:36166701 | DOI:10.1093/humrep/deac211

Biom J. 2022 Sep 27. doi: 10.1002/bimj.202200073. Online ahead of print.

ABSTRACT

Common count distributions, such as the Poisson (binomial) distribution for unbounded (bounded) counts considered here, can be characterized by appropriate Stein identities. These identities, in turn, might be utilized to define a corresponding goodness-of-fit (GoF) test, the test statistic of which involves the computation of weighted means for a user-selected weight function f. Here, the choice of f should be done with respect to the relevant alternative scenario, as it will have great impact on the GoF-test’s performance. We derive the asymptotics of both the Poisson and binomial Stein-type GoF-statistic for general count distributions (we also briefly consider the negative-binomial case), such that the asymptotic power is easily computed for arbitrary alternatives. This allows for an efficient implementation of optimal Stein tests, that is, which are most powerful within a given class F$mathcal {F}$ of weight functions. The performance and application of the optimal Stein-type GoF-tests is investigated by simulations and several medical data examples.

PMID:36166681 | DOI:10.1002/bimj.202200073

Am J Phys Med Rehabil. 2022 Sep 23. doi: 10.1097/PHM.0000000000002111. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the effectiveness of a rehabilitation program with electromyographic biofeedback (EMG-BF) compared to the control group on patients with massive rotator cuff (RC) tear.

DESIGN: Forty-six adults with massive RC tears, randomly assigned to two groups (23 EMG-BF group vs. 23 Control group). The EMG-BF group (experimental group) performed the exercises under the guidance of EMG-BF, unlike the control group. All patients underwent a 45-minute training session a day, three times a week over a 6-week duration, and followed up until 1-year. The outcome measures were American Shoulder and Elbow (ASES) score, shoulder flexion strength, shoulder range of motion (ROM), numeric pain rating scale (NPRS), and Global Rating of Change Scale (GRCS).

RESULTS: Compared with the control group, the EMG-BF group demonstrated a significant change in shoulder flexion strength and patient satisfaction from baseline to 6 weeks (post-training) and from baseline to 12-month follow-up (F = 4.671, P = 0.005). There were significant improvements in within groups statistics for ASES score, shoulder flexion strength, shoulder ROM, and NPRS in both groups (p < 0.05).

CONCLUSION: The results demonstrate that deltoid focused structured rehabilitation program combined with EMG-BF can be used to increase shoulder flexion strength and patient satisfaction in conservative treatment of massive RC tear.

PMID:36166658 | DOI:10.1097/PHM.0000000000002111

JMIR Form Res. 2022 Sep 7. doi: 10.2196/41410. Online ahead of print.

ABSTRACT

BACKGROUND: There are around 1.3million people in the UK living with the devastating psychological, physical and cognitive consequences of Long COVID. UK guidelines recommend that Long COVID symptoms are managed pragmatically with holistic support for patients’ biopsychosocial needs, including psychological, emotional, and physical health. Self-management strategies such as pacing, prioritisation, and goal setting are vital for the self-management of many Long COVID symptoms. This paper describes the co-development and initial testing of a digital intervention combining peer support with positive psychology approaches for self-managing the physical, emotional, psychological, and cognitive challenges associated with Long COVID.

OBJECTIVE: The objectives of this study were to: i) co-design an intervention with and for people living with Long COVID; ii) test the intervention and study methods; iii) measure changes in participant wellbeing, self-efficacy, fatigue and loneliness; iv) gain understand the types of self-management goals and strategies used by people living with Long COVID.

METHODS: The study employed a pre-post, mixed methods, pragmatic, uncontrolled design. Digital intervention content was co-developed with a lived experience group to meet the needs uncovered during the intervention development and logic mapping phase. The resulting 8-week digital intervention – Hope Program for Long COVID – was attended by 47 participants, who completed pre- and post-program measures of wellbeing, self-efficacy, fatigue and loneliness. Goal-setting data was extracted from the digital platform at the end of the intervention.

RESULTS: The recruitment rate (83.9%) and follow up rate of (59.6%) were encouraging. Positive mental wellbeing (mean difference 6.5, p<.001) and self-efficacy (mean difference 1.1, p=.009) improved from baseline to post-course. All goals set by participants mapped onto the five goal-directed everyday self-management strategies in the TEDSS taxonomy. The most frequent type of goals related to activities strategies, followed by health behaviour and internal strategies.

CONCLUSIONS: The bespoke self-management intervention -Hope Program for Long COVID – was well-attended and follow up was encouraging. The sample characteristics largely mirrored those of the wider UK population living with Long COVID. Although not powered to detect statistically significant changes, the preliminary data shows improvements in self-efficacy and positive mental wellbeing. Our next trial (ISRCTN: 11868601) will employ a non-randomised waitlist control design to further examine intervention efficacy.

PMID:36166651 | DOI:10.2196/41410