Nevin Manimala

Front Aging Neurosci. 2023 Jan 5;14:939155. doi: 10.3389/fnagi.2022.939155. eCollection 2022.

ABSTRACT

BACKGROUND: The usefulness of neurofilament light (NfL) as a biomarker for small vessel disease has not been established. We examined the relationship between NfL, neuroimaging changes, and clinical findings in subjects with varying degrees of white matter hyperintensity (WMH).

METHODS: A subgroup of participants (n = 35) in the Helsinki Small Vessel Disease Study underwent an analysis of NfL in cerebrospinal fluid (CSF) as well as brain magnetic resonance imaging (MRI) and neuropsychological and motor performance assessments. WMH and structural brain volumes were obtained with automatic segmentation.

RESULTS: CSF NfL did not correlate significantly with total WMH volume (r = 0.278, p = 0.105). However, strong correlations were observed between CSF NfL and volumes of cerebral grey matter (r = -0.569, p < 0.001), cerebral cortex (r = -0.563, p < 0.001), and hippocampi (r = -0.492, p = 0.003). CSF NfL also correlated with composite measures of global cognition (r = -0.403, p = 0.016), executive functions (r = -0.402, p = 0.017), memory (r = -0.463, p = 0.005), and processing speed (r = -0.386, p = 0.022). Regarding motor performance, CSF NfL was correlated with Timed Up and Go (TUG) test (r = 0.531, p = 0.001), and gait speed (r = -0.450, p = 0.007), but not with single-leg stance. After adjusting for age, associations with volumes in MRI, functional mobility (TUG), and gait speed remained significant, whereas associations with cognitive performance attenuated below the significance level despite medium to large effect sizes.

CONCLUSION: NfL was strongly related to global gray matter and hippocampal atrophy, but not to WMH severity. NfL was also associated with motor performance. Our results suggest that NfL is independently associated with brain atrophy and functional mobility, but is not a reliable marker for cerebral small vessel disease.

PMID:36688160 | PMC:PMC9849573 | DOI:10.3389/fnagi.2022.939155

Front Med Technol. 2023 Jan 4;4:1007708. doi: 10.3389/fmedt.2022.1007708. eCollection 2022.

ABSTRACT

INTRODUCTION: Artificial intelligence and data-driven predictive modeling have become increasingly common tools integrated in clinical practice, heralding a new chapter of medicine in the digital era. While these techniques are poised to affect nearly all aspects of medicine, medical education as an institution has languished behind; this has raised concerns that the current training infrastructure is not adequately preparing future physicians for this changing clinical landscape. Our institution attempted to ameliorate this by implementing a novel artificial intelligence in radiology curriculum, “AI-RADS,” in two different educational formats: a 7-month lecture series and a one-day workshop intensive.

METHODS: The curriculum was structured around foundational algorithms within artificial intelligence. As most residents have little computer science training, algorithms were initially presented as a series of simple observations around a relatable problem (e.g., fraud detection, movie recommendations, etc.). These observations were later re-framed to illustrate how a machine could apply the underlying concepts to perform clinically relevant tasks in the practice of radiology. Secondary lessons in basic computing, such as data representation/abstraction, were integrated as well. The lessons were ordered such that these algorithms were logical extensions of each other. The 7-month curriculum consisted of seven lectures paired with seven journal clubs, resulting in an AI-focused session every two weeks. The workshop consisted of six hours of content modified for the condensed format, with a final integrative activity.

RESULTS: Both formats of the AI-RADS curriculum were well received by learners, with the 7-month version and workshop garnering 9.8/10 and 4.3/5 ratings, respectively, for overall satisfaction. In both, there were increases in perceived understanding of artificial intelligence. In the 7-lecture course, 6/7 lectures achieved statistically significant (P < 0.02) differences, with the final lecture approaching significance (P = 0.07). In the one-day workshop, there was a significant increase in perceived understanding (P = 0.03).

CONCLUSION: As artificial intelligence becomes further enmeshed in clinical practice, it will become critical for physicians to have a basic understanding of how these tools work. Our AI-RADS curriculum demonstrates that it is successful in increasing learner perceived understanding in both an extended and condensed format.

PMID:36688145 | PMC:PMC9845918 | DOI:10.3389/fmedt.2022.1007708

Front Med Technol. 2023 Jan 4;4:1055189. doi: 10.3389/fmedt.2022.1055189. eCollection 2022.

ABSTRACT

BACKGROUND: Anterior cervical discectomy and fusion (ACDF) is an often performed procedure in spine neurosurgery. These are often performed using an operating microscope (OM) for better illumination and visualization. But its use is limited to the surgeon and the assistant. There is difficulty in maneuvering long surgical instruments due to the limited space available. Exoscope (EX) has been used as an alternative to microscopes and endoscopes. We used an EX in patients undergoing ACDF for cervical spondylotic myelopathy.

METHODS: A prospective comparative trial was conducted to test the safety and usability of a low-cost EX compared to a conventional surgical binocular OM in ACDF. Twenty-six patients with degenerative cervical myelopathy symptoms were operated by ACDF assisted by the EX and OM between December 2021 and June 2022. The authors collected and compared data on operative time, intraoperative hemorrhage, hospital admission, and complications in the two groups.

RESULTS: There were no statistically significant differences between the two groups in mean operative time, hospital stay, or postoperative complications. The average intraoperative blood loss was significantly more in the OM group. There were no surgical complications related to the use of the EX or OM. The comfort level, preoperative setup and intraoperative adjustment of position and angle of the EX were rated higher than the OM group. The image quality, depth perception, and illumination were rated as inferior to that of the OM. The low-cost EX was rated to be superior to that of the OM with regard to education and training purposes.

CONCLUSION: Our study showed that the low-cost EX appears to be a safe and effective alternative for OM-assisted ACDF with great comfort and ergonomics and serves as an essential tool for education and training purposes. However, some limitations of our EX included slightly inferior image quality and illumination when compared with the OM.

PMID:36688142 | PMC:PMC9846206 | DOI:10.3389/fmedt.2022.1055189

JAAD Int. 2022 Nov 13;10:68-74. doi: 10.1016/j.jdin.2022.11.002. eCollection 2023 Mar.

ABSTRACT

BACKGROUND: Atopic dermatitis (AD) is a chronic, inflammatory skin disease commonly onset during infancy.

OBJECTIVE: We examine the association between pre-and postnatal antibiotic exposure and the development of AD.

METHODS: A retrospective, observational study analyzed 4106 infants at the University of Florida from June 2011 to April 2017.

RESULTS: Antibiotic exposure during the first year of life was associated with a lower risk of AD. The association was strongest for exposure during the first month of life. There were no significant differences in the rates of AD in infants with or without exposure to antibiotics in months 2 through 12, when examined by month. Antibiotic exposure during week 2 of life was associated with lower risk of AD, with weeks 1, 3, and 4 demonstrating a similar trend.

LIMITATIONS: Retrospective data collection from a single center, use of electronic medical record, patient compliance with prescribed medication, and variable follow-up.

CONCLUSIONS: Early life exposures, such as antibiotics, may lead to long-term changes in immunity. Murine models of atopic dermatitis demonstrate a “critical window” for the development of immune tolerance to cutaneous microbes. Our findings suggest that there may also be a “critical window” for immune tolerance in human infants, influenced by antibiotic exposure.

PMID:36688099 | PMC:PMC9850168 | DOI:10.1016/j.jdin.2022.11.002

Int J Nurs Knowl. 2023 Jan 22. doi: 10.1111/2047-3095.12413. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: Identifying and evaluating the strengths and weaknesses of nursing care provided to improve the quality of nursing care is increasingly emphasized, and it requires using valid tools in this field. This study aimed to translate and determine the psychometric properties of the Persian version of the “Good Nursing Care Scale” (GNCS-P).

METHODS: The present study is a methodological study in which the psychometric dimensions of GNCS-P were studied from the perspective of 200 patients who were admitted to the hospitals of Ardabil University of Medical Sciences. After translating the original version of the scale, its validity and reliability were evaluated and data analysis was performed using statistical package for social science (version 16) and analysis of moment structures (version 24).

RESULTS: The effect score of the item in the evaluation of face validity for each item was above 2.4. The content validity ratio for the scale was 0.88, and the content validity index tool was 0.86. The correlation of total instrument scores with the standard instrument was 0.839. According to the results of factor analysis, the values of factor loading of items were between 0.62 and 0.91, which were all significant. Therefore, the seven dimensions introduced in the main tool were approved. In addition, Cronbach’s alpha results of 0.865 and correlation of 0.894 in the test-retest showed that the questionnaire has internal consistency and acceptable stability.

CONCLUSION: The Persian version of the GNCS-P has acceptable psychometric properties in the Iranian population and can be used as a valid tool in the areas of quality assessment of nursing care, education, and nursing research.

IMPLICATIONS FOR NURSING PRACTICE: The results showed the validity and reliability of the tool and its usability as a valid tool in evaluating the quality of nursing care.

PMID:36683201 | DOI:10.1111/2047-3095.12413

Int J Hyperthermia. 2023;40(1):2168075. doi: 10.1080/02656736.2023.2168075.

ABSTRACT

OBJECTIVE: To use logistic regression to analyze the attributes underlying patients’ treatment options for low-grade squamous intraepithelial lesion (LSIL) complicated with high-risk human papillomavirus (HR-HPV) infection, and identify the best benefit group of different treatment options.

METHODS: Clinical data of 197 LSIL patients with HR-HPV infection between June 2009 and February 2022 were collected. According to the treatment options chosen by the patients, they were divided into the interferon, photodynamic therapy, follow-up observation, and focused ultrasound (FUS) treatment groups. One-way analysis of variance (ANOVA) and multivariate logistic regression analysis were used to analyze the influencing factors, including age, occupation, education level, maternity history, reason for encounter, route of consultation, annual personal and household income, screening for related risk factors, and identifying the best benefit group of different treatment options.

RESULTS: One-way ANOVA revealed a statistically significant difference in age, education level, maternity history, reason for encounter, and annual household income (p < 0.05). Multivariate logistic regression analysis was performed on these five factors, indicating that age ≤35 years, high school educational level or higher, and no childbirth history were independent risk factors influencing patients’ choices of FUS treatment. The receiver operating characteristic curve was used to determine the age threshold of 31 years.

CONCLUSION: Age, educational level, and maternity history were independent risk factors influencing patients’ choice of treatment modality for LSIL complicated with HR-HPV infection. Age ≤31 years, high school, equivalent, or higher educational level, and no childbirth yielded a higher rate of choosing FUS treatment for LSIL patients with HR-HPV infection.

PMID:36683163 | DOI:10.1080/02656736.2023.2168075

J Forensic Sci. 2023 Jan 22. doi: 10.1111/1556-4029.15192. Online ahead of print.

ABSTRACT

Human hairs are one of the most commonly encountered items of trace evidence. Currently, conventional methods for hair analysis include microscopic comparison and DNA analysis (nuclear and mitochondrial). Each approach has its own drawbacks. Hair proteins are stable and offer an alternative to DNA testing, as demonstrated with proteomics for distinguishing humans. However, proteomics is complicated and requires identifying peptides to remain intact following harsh sample preparation methods. Alternatively, the actual amino acid content of a hair sample may also offer important identifying information and actually requires proteins and peptides to be broken down completely rather than remaining intact. This study evaluated the discriminating power of using hair amino acid ratios to differentiate hair samples from 10 unrelated individuals with dark colored hair. Hair proteins were digested, derivatized, and analyzed using gas chromatography-mass spectrometry. Amino acid ratios were calculated for each individual and comparisons using ANOVA and post-hoc pairwise t-test with Bonferroni correction were made with amino acid ratios for individuals. Overall, out of the 45 possible pairwise comparisons between all hair samples, 38 (84%) were differentiable. Out of the 36 possible pairwise comparisons between brown haired individuals, 32 (89%) were considered differentiable using univariate statistics. Multivariate statistics were also attempted but, overall, univariate models were sufficient for exclusionary purposes. These results indicate that amino acid ratio analysis can potentially be used as an exclusionary method using hair if DNA analysis cannot be performed, or to corroborate conclusions made following microscopic analysis.

PMID:36683150 | DOI:10.1111/1556-4029.15192

Environ Monit Assess. 2023 Jan 23;195(2):319. doi: 10.1007/s10661-022-10909-9.

ABSTRACT

This study aims to compare three popular machine learning (ML) algorithms including random forest (RF), boosting regression tree (BRT), and multinomial logistic regression (MnLR) for spatial prediction of groundwater quality classes and mapping it for salinity hazard. Three hundred eighty-six groundwater samples were collected from an agriculturally intensive area in Fars Province, Iran, and nine hydro-chemical parameters were defined and interpreted. Variance inflation factor and Pearson’s correlations were used to check collinearity between variables. Thereinafter, the performance of ML models was evaluated by statistical indices, namely, overall accuracy (OA) and Kappa index obtained from the confusion matrix. The results showed that the RF model was more accurate than other models with the slight difference. Moreover, the analysis of relative importance also indicated that sodium adsorption ratio (SAR) and pH have the most impact parameters in explaining groundwater quality classes, respectively. In this research, applied ML algorithms along with the hydro-chemical parameters affecting the quality of ground water can lead to produce spatial distribution maps with high accuracy for managing irrigation practice.

PMID:36683118 | DOI:10.1007/s10661-022-10909-9

Environ Sci Pollut Res Int. 2023 Jan 23. doi: 10.1007/s11356-023-25349-2. Online ahead of print.

ABSTRACT

This research aims to investigate the appropriate ownership structure via mediating role of corporate sustainability on corporate performance in state-owned companies of Pakistan by examining the role of organizational governance, agency problems, and current issue of CEO ownership. Most effective theories within the context of the developing country of Pakistan are taken into account and study explores the following issue. First, ownership structure is more effective and could provide major findings in corporate, innovative, and environmental performance. Second, corporate, innovative, and environmental performance is receiving high attention due to the critical business environment in Pakistan. There are many factors that stimulate the significance of the corporate, innovative, and environmental performance. In this phase, the role of CEO and responsibilities towards the company and its performance is analyzed. This study has conducted the theoretical survey in both foreign and home countries. Further, this step is hallmark in providing some countermeasures recommendation for the betterment of state-owned companies of Pakistan. Third is whether the CEOs and shareholders could enhance the corporate, innovative, and environmental performance. Empirical evidence data is collected via structured questionnaire from SO companies operating in the emerging market of Pakistan. In addition, empirical research in this study includes descriptive statistics tests, co-relation test, and analyses generated hypotheses through Analysis of a Moment Structure (AMOS) using structural equation modeling. Our research findings recommend CEOs and top managers to utilize their financial resources in an efficient way to achieve the advantage.

PMID:36683108 | DOI:10.1007/s11356-023-25349-2

Environ Sci Pollut Res Int. 2023 Jan 23. doi: 10.1007/s11356-022-25115-w. Online ahead of print.

ABSTRACT

As an important drinking water source for North China, the Middle Route of China’s South-to-North Water Diversion Project (MRP) must provide high-quality water to maintain the health and safety of more than 60 million people. However, different water transfer operation modes may affect the water quality status, and the spatiotemporal characteristics of water quality in the MRP, with high water transfer volumes, remain poorly understood. In this study, the differences in water quality in the MRP between the initial stage (Nov. 2015 to Oct. 2017, low transfer volumes) and the current stage (Nov. 2017 to Oct. 2020, high transfer volumes) were compared, and the spatiotemporal water quality variations in the current stage were evaluated using multivariate statistical methods. For this purpose, approximately 12,528 observations, including the datasets of 12 water quality parameters collected from 29 monitoring sites, were used. The results showed that the water quality status improved significantly during the current stage. Based on principal component analysis (PCA), physical parameters (natural), nutrients, organic matter and microbes (anthropogenic), and heavy metals (natural and anthropogenic) were the key factors influencing water quality variations. Based on hierarchical cluster analysis, 12 months were classified into two groups: the high-flow period (HFP, Jun.-Oct.) and the low-flow period (LFP, Nov.-May). Additionally, 29 sampling sites were grouped into three sections: the Henan section (HN; S1-S16), Hebei section (HB; S17-S24), and Tianjin-Beijing section (TB; S25-S29). From the perspective of water quality regulation, the total nitrogen concentration and permanganate index in the HB and TB sections of the MRP should be considered throughout the year, and the faecal coliform concentrations in these two sections should also be considered during the HFP. The results of this study could be helpful for local administrations to understand and control pollution and better protect the quality of water in the MRP.

PMID:36683107 | DOI:10.1007/s11356-022-25115-w