Nevin Manimala

Ear Nose Throat J. 2023 Apr 17:1455613231170088. doi: 10.1177/01455613231170088. Online ahead of print.

ABSTRACT

OBJECTIVE: To analyze the clinical characteristics of differentiated thyroid cancer (DTC) patients with nasolacrimal duct obstruction (NLDO) after Iodine-131 (¹³¹I) therapy and provide guidance for clinical decision-making.

METHODS: Thirty-one DTC patients with NLDO were retrospectively enrolled from the Nuclear Medicine Department of Shanxi Bethune Hospital during follow-up of ¹³¹I therapy between June 2018 and March 2021. Eight hundred and seventy-one thyroid cancer patients during this period without NLDO after ¹³¹I therapy were enrolled as the control group. Clinical characteristics, including sex, age, dose, anti-thyroglobulin antibodies (TGAb), and metastatic lesions, were analyzed by χ² test and logistic multifactor regression.

RESULTS: In the NLDO group and without NLDO group, there were statistically significant differences in gender, age, dose, and whether there was metastasis. Among the NLDO group, the proportion of women, age >55 years old, dose >5.55 GBq, and the presence of metastasis was higher, and the difference was statistically significant; There was no significant difference in the proportion of TGAb positive and negative patients based on ¹³¹I therapy (χ² = 0.27, P = .782).Multivariate logistic regression analysis showed that sex (2.59), age (1.45), dose (2.36), and metastatic lesions (1.93) were all statistically significant influential factors of NLDO after iodine therapy. Significant differences were found in the incidence of NLDO between the number of treatment courses (χ² = 23.541, P < .001). Prevalence rate of repeat radioiodine therapy (2 times or 3 times and more) is higher than 1 time.

CONCLUSION: Women patients over 55 who had metastatic lesions, and received a dose >5.55 GBq, were more likely to have NLDO. When determining therapeutic doses of ¹³¹I, doctors should weigh multiple factors and then give appropriate dosage and suggest that high risk populations be referred for appropriate ophthalmic surgical consultation, for timely diagnosis and therapy.

PMID:37070248 | DOI:10.1177/01455613231170088

Clin Exp Allergy. 2023 Apr 17. doi: 10.1111/cea.14318. Online ahead of print.

NO ABSTRACT

PMID:37070243 | DOI:10.1111/cea.14318

Acta Radiol. 2023 Apr 17:2841851231165487. doi: 10.1177/02841851231165487. Online ahead of print.

ABSTRACT

BACKGROUND: Computed tomography (CT) is the reference standard for assessment of the bone. Magnetic resonance imaging (MRI) developments enable a CT-like visualization of the osseous structures.

PURPOSE: To assess the diagnostic performance of 3D zero-echo time (3D-ZTE) and 3D T1-weighted gradient-echo (3D-T1GRE) MRI sequences for the evaluation of lumbar facet joints (LFJs) and the detection of lumbosacral transitional vertebrae (LSTV) using CT as the reference standard.

MATERIAL AND METHODS: In total, 87 adult patients were included in this prospective study. Evaluation of degenerative changes of the facet joints at the L3/L4, L4/L5, and L5/S1 levels on both sides was performed by two readers using a 4-point Likert scale. LSTV were classified according to Castelvi et al. Image quality was quantitatively measured using the signal-to-noise (SNR) and contrast-to-noise (CNR) ratios. Intra-reader, inter-reader, and inter-modality reliability were calculated using Cohen’s kappa statistic.

RESULTS: Intra-reader agreement for 3D-ZTE, 3D-T1GRE, and CT was 0.607, 0.751, and 0.856 and inter-reader agreement was 0.535, 0.563, and 0.599, respectively. The inter-modality agreement between 3D-ZTE and CT was 0.631 and between 3D-T1GRE and CT 0.665. A total of LSTV were identified in both MR sequences with overall comparable accuracy compared to CT. Mean SNR for bone, muscle, and fat was highest for 3D-T1GRE and mean CNR was highest for CT.

CONCLUSION: 3D-ZTE and 3D-T1GRE MRI sequences can assess the LFJs and LSTV and may serve as potential alternatives to CT.

PMID:37070233 | DOI:10.1177/02841851231165487

Waste Manag Res. 2023 Apr 17:734242X231167341. doi: 10.1177/0734242X231167341. Online ahead of print.

ABSTRACT

The complexity of waste management (WM) problems resulted in the explosion of scenarios that challenge focused discussion among stakeholders and hinder the integrity of policy responses in developing countries. Hence, drawing similarities is essential to reduce the number of scenarios to simplify the WM efforts. To extract similarities, measuring WM performance is not enough, but the background factors related to this performance should be incorporated. These factors form a unique system characteristic that facilitates or hinders WM functions. Thus, this study applied multivariate statistical analysis to clarify underlying characteristics that facilitate efficient WM scenario developments for developing countries. The study first analysed drivers associated with improved WM system performance using bivariate correlation analysis. As a result, twelve significant drivers associated with controlled solid waste were identified. Then, it mapped the countries based on their WM system characteristics using the combined principal component analysis and hierarchical clustering approach. Thirteen variables were examined to extract similarities between the countries. The results identified three homogenous clusters. The clusters were found considerably parallel to the global classifications based on income and human development index. Hence, the presented approach is efficient in explaining similarities that reduce WM scenarios and favours cooperation among countries.

PMID:37070219 | DOI:10.1177/0734242X231167341

Clin Endosc. 2023 Apr 17. doi: 10.5946/ce.2022.166. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: Colonic volvulus (CV), a common cause of bowel obstruction, often requires intervention. We aimed to identify hospitalization trends and CV outcomes in the United States.

METHODS: We used the National Inpatient Sample to identify all adult CV hospitalizations in the United States from 2007 to 2017. Patient demographics, comorbidities, and inpatient outcomes were highlighted. Outcomes of endoscopic and surgical management were compared.

RESULTS: Between 2007 and 2017, there were 220,666 CV hospitalizations. CV-related hospitalizations increased from 17,888 in 2007 to 21,715 in 2017 (p=0.001). However, inpatient mortality decreased from 7.6% in 2007 to 6.2% in 2017 (p<0.001). Of all CV-related hospitalizations, 13,745 underwent endoscopic intervention, and 77,157 underwent surgery. Although the endoscopic cohort had patients with a higher Charlson comorbidity index, we noted lower inpatient mortality (6.1% vs. 7.0%, p<0.001), mean length of stay (8.3 vs. 11.8 days, p<0.001), and mean total healthcare charge ($68,126 vs. $106,703, p<0.001) compared to the surgical cohort. Male sex, increased Charlson comorbidity index scores, acute kidney injury, and malnutrition were associated with higher odds of inpatient mortality in patients with CV who underwent endoscopic management.

CONCLUSIONS: Endoscopic intervention has lower inpatient mortality and is an excellent alternative to surgery for appropriately selected CV hospitalizations.

PMID:37070205 | DOI:10.5946/ce.2022.166

Nucleic Acids Res. 2023 Apr 18:gkad284. doi: 10.1093/nar/gkad284. Online ahead of print.

ABSTRACT

Over the last decade, Haplogrep has become a standard tool for haplogroup classification in the field of human mitochondrial DNA and is widely used by medical, forensic, and evolutionary researchers. Haplogrep scales well for thousands of samples, supports many file formats and provides an intuitive graphical web interface. Nevertheless, the currently available version has limitations when applying it to large biobank-scale data. In this paper, we present a major upgrade to the software by adding (a) haplogroup summary statistics and variant annotations from various publicly available genome databases, (b) an interface to connect new phylogenetic trees, (c) a new state-of-the-art web framework managing large scale data, (d) algorithmic adaptions to improve FASTA classification using BWA-specific alignment rules and (e) a pre-classification quality control step for VCF samples. These improvements will give researchers the opportunity to classify thousands of samples as usual but providing additional ways to investigate the dataset directly in the browser. The web service and its documentation can be accessed freely without any registration at https://haplogrep.i-med.ac.at.

PMID:37070190 | DOI:10.1093/nar/gkad284

Ann Cardiol Angeiol (Paris). 2023 Apr 15;72(3):101598. doi: 10.1016/j.ancard.2023.101598. Online ahead of print.

ABSTRACT

BACKGROUND: French health authorities recommend implementing a strong coordination between general practitioners and office-based cardiologists for the care and management of patients with chronic heart failure. The aim of this study was to describe the characteristics of patients with chronic heart failure who were infrequently referred to an office-based cardiologist (either first time referral or last visit more than 12 months before study inclusion) by a general practitioner or other healthcare professional versus those who were regularly followed by a general practitioner and an office-based cardiologist (at least one visit to an office-based cardiologist in the last 12 months).

METHODS: This was a non-interventional, cross-sectional study, conducted among office-based cardiologists in France during a single study visit. Descriptive statistics were performed.

RESULTS: 1460 patients were included in the study with 37.1% in the group infrequently referred to an office-based cardiologist and 62.9% in the regularly followed group. The patients who were infrequently referred to an office-based cardiologist had relatively less heart failure with reduced ejection fraction (29.2% versus 36.6%), less prior chronic heart failure hospitalization (15.9% versus 31.4%), and less atrial fibrillation and ischemic heart failure as comorbidities (40.2% versus 50.5% and 39.3% versus 50.1%, respectively) than patients who were regularly followed by an office-based cardiologist and a general practitioner. They also received less clinical exams (25.5% versus 97.4%) and pharmacological (89.3% versus 98.4%) and non-pharmacological (17.3% versus 27.1%) heart failure treatments before the study visit.

CONCLUSIONS: This study suggested that patients regularly followed by a general practitioner and an office-based cardiologist had globally a more severe chronic heart failure and a better medical monitoring and follow-up than other patients.

PMID:37068350 | DOI:10.1016/j.ancard.2023.101598

Ann Intern Med. 2023 Apr 18. doi: 10.7326/M22-1628. Online ahead of print.

ABSTRACT

BACKGROUND: More evidence is needed to substantiate current recommendations about removing ovaries during hysterectomy for benign conditions.

OBJECTIVE: To compare long-term outcomes in women with and without bilateral salpingo-oophorectomy (BSO) during hysterectomy for benign conditions.

DESIGN: Emulated target trial using data from a population-based cohort.

SETTING: Women in Denmark aged 20 years or older during 1977 to 2017.

PARTICIPANTS: 142 985 women with hysterectomy for a benign condition, 22 974 with BSO and 120 011 without.

INTERVENTION: Benign hysterectomy with or without BSO.

MEASUREMENTS: The primary outcomes were overall hospitalization for cardiovascular disease (CVD), overall cancer incidence, and all-cause mortality through December 2018.

RESULTS: Compared with women without BSO, women with BSO who were younger than 45 years at surgery had a higher 10-year cumulative risk for hospitalization for CVD (risk difference [RD], 1.19 percentage points [95% CI, 0.09 to 2.43 percentage points]). Women with BSO had a higher 10-year cumulative risk for cancer for ages 45 to 54 years (RD, 0.73 percentage point [CI, 0.05 to 1.38 percentage points]), 55 to 64 years (RD, 1.92 percentage points [CI, 0.69 to 3.25 percentage points]), and 65 years or older (RD, 2.54 percentage points [CI, 0.91 to 4.25 percentage points]). Women with BSO had higher 10-year mortality in all age groups, although the differences were statistically significant only for ages 45 to 54 years (RD, 0.79 percentage point [CI, 0.27 to 1.30 percentage points]). The mortality at 20 years was inconsistent with that at 10 years in women aged 65 years or older.

LIMITATION: Age was a proxy for menopausal status.

CONCLUSION: The authors find that these results support current recommendations for conserving ovaries in premenopausal women without a high risk for ovarian cancer and suggest a cautious approach in postmenopausal women.

PRIMARY FUNDING SOURCE: The Danish Cancer Society’s Scientific Committee and the Mermaid Project.

PMID:37068275 | DOI:10.7326/M22-1628

Biom J. 2023 Apr 17:e2100368. doi: 10.1002/bimj.202100368. Online ahead of print.

ABSTRACT

We propose a semiparametric mean residual life mixture cure model for right-censored survival data with a cured fraction. The model employs the proportional mean residual life model to describe the effects of covariates on the mean residual time of uncured subjects and the logistic regression model to describe the effects of covariates on the cure rate. We develop estimating equations to estimate the proposed cure model for the right-censored data with and without length-biased sampling, the latter is often found in prevalent cohort studies. In particular, we propose two estimating equations to estimate the effects of covariates in the cure rate and a method to combine them to improve the estimation efficiency. The consistency and asymptotic normality of the proposed estimates are established. The finite sample performance of the estimates is confirmed with simulations. The proposed estimation methods are applied to a clinical trial study on melanoma and a prevalent cohort study on early-onset type 2 diabetes mellitus.

PMID:37068192 | DOI:10.1002/bimj.202100368

Biom J. 2023 Apr 17:e2200153. doi: 10.1002/bimj.202200153. Online ahead of print.

ABSTRACT

Buckley-James (BJ) model is a typical semiparametric accelerated failure time model, which is closely related to the ordinary least squares method and easy to be constructed. However, traditional BJ model built on linearity assumption only captures simple linear relationships, while it has difficulty in processing nonlinear problems. To overcome this difficulty, in this paper, we develop a novel regression model for right-censored survival data within the learning framework of BJ model, basing on random survival forests (RSF), extreme learning machine (ELM), and L₂ boosting algorithm. The proposed method, referred to as ELM-based BJ boosting model, employs RSF for covariates imputation first, then develops a new ensemble of ELMs-ELM-based boosting algorithm for regression by ensemble scheme of L₂ boosting, and finally, uses the output function of the proposed ELM-based boosting model to replace the linear combination of covariates in BJ model. Due to fitting the logarithm of survival time with covariates by the nonparametric ELM-based boosting method instead of the least square method, the ELM-based BJ boosting model can capture both linear covariate effects and nonlinear covariate effects. In both simulation studies and real data applications, in terms of concordance index and integrated Brier sore, the proposed ELM-based BJ boosting model can outperform traditional BJ model, two kinds of BJ boosting models proposed by Wang et al., RSF, and Cox proportional hazards model.

PMID:37068191 | DOI:10.1002/bimj.202200153