Nevin Manimala

Eur J Radiol. 2021 Nov 15;145:110041. doi: 10.1016/j.ejrad.2021.110041. Online ahead of print.

ABSTRACT

OBJECTIVE: To develop and validate a deep learning nomogram (DLN) model constructed from non-contrast computed tomography (CT) images for discriminating minimally invasive adenocarcinoma (MIA) from invasive adenocarcinoma (IAC) in patients with subsolid pulmonary nodules (SSPNs).

MATERIALS AND METHODS: In total, 365 consecutive patients who presented with SSPNs and were pathologically diagnosed with MIA or IAC after surgery, were recruited from two medical institutions from 2016 to 2019. Deep learning features were selected from preoperative CT images using convolutional neural network. Deep learning signature (DLS) was developed via the least absolute shrinkage and selection operator (LASSO). New DLN integrating clinical variables, subjective CT findings, and DLS was constructed. The diagnostic efficiency and discriminative capability were analyzed using the receiver operating characteristic method and decision curve analysis (DCA).

RESULTS: In total, 18 deep learning features with non-zero coefficients were enrolled to develop the DLS, which was statistically different between the MIA and IAC groups. Independent predictors of DLS and lobulated sharp were used to build the DLN. The areas under the curves of the DLN were 0.889 (95% confidence interval (CI): 0.824-0.936), 0.915 (95% CI: 0.846-0.959), and 0.914 (95% CI: 0.848-0.958) in the training, internal validation, and external validation cohorts, respectively. After stratification analysis and DCA, the DLN showed potential generalization ability.

CONCLUSION: The DLN incorporating the DLS and subjective CT findings have strong potential to distinguish MIA from IAC in patients with SSPNs, and will facilitate the suitable treatment method selection for the management of SSPNs.

PMID:34837794 | DOI:10.1016/j.ejrad.2021.110041

J Stroke Cerebrovasc Dis. 2021 Nov 24;31(2):106225. doi: 10.1016/j.jstrokecerebrovasdis.2021.106225. Online ahead of print.

ABSTRACT

BACKGROUND AND PURPOSE: Post-stroke depression (PSD) is a common psychiatric complication of stroke and is associated with the subsequent prognosis, yet still lacking of enough attention. PSD is preventable, and psychotherapy is an alternative prophylactic treatment which needs more solid evidences to confirm its efficacy. In this study, group Acceptance and Commitment Therapy (G-ACT) was performed in acute stroke patients to see if it can effectively relieve depressive symptoms and improve neurological function. The efficacy was also evaluated in stroke patients of different severity.

METHODS: One hundred and four hospitalized patients with acute ischemic stroke were enrolled according to the inclusion criteria and exclusion criteria. After baseline evaluation, they were randomly allocated to the intervention (G-ACT) group and the control (usual care) group. Patients in the control group received routine stroke treatment, while those in the intervention group were given additional G-ACT treatment (5 sessions, 45-55 min/session). Both of the two groups were assessed with 24-item Hamilton Depression Scale (HAMD-24), National Institutes of Health Stroke Scale (NIHSS), and Barthel Index (BI) at baseline, 2 weeks, 1 month, and 3 months follow-up. Patients were further divided into the mild stroke group (NIHSS 0-3) and the moderate stroke group (NIHSS 4-9), HAMD scores at different time points were also assessed.

RESULTS: The HAMD score of G-ACT group was significantly lower than that of control group at 1 month (p = 0.018) and 3 months follow-up (p = 0.001). As to the NIHSS score, there was no significant difference between the two groups within the follow-up period (p > 0.05). The BI score of the two groups was statistically different at 2 weeks (p = 0.033) and 1 month (p = 0.019), while no difference was shown at 3 months (p = 0.191). In acute phase, the HAMD score of moderate stroke patients was significantly higher than that of mild ones (p < 0.001). After G-ACT treatment, both mild and moderate stroke patients showed lower HAMD score at 3 months follow-up (p = 0.004; p = 0.033).

CONCLUSIONS: G-ACT seems to be a viable and effective treatment for preventing PSD in the acute phase of stroke, while the efficacy of which on improving neurological deficits needs to be further evaluated.

PMID:34837758 | DOI:10.1016/j.jstrokecerebrovasdis.2021.106225

J Surg Res. 2021 Nov 24;271:41-51. doi: 10.1016/j.jss.2021.10.018. Online ahead of print.

ABSTRACT

BACKGROUND: Less than half of medical school professorships and decanal ranks are held by women. Our study investigates the gender-based geographical distribution and differences in lifetime peer-reviewed publications, H-index, and grant funding by the National Institutes of Health (NIH) of all allopathic medical school deans in the United States (US).

METHODS: A cross-sectional cohort study utilizing data from US allopathic medical school websites, PubMed, and the NIH Research Portfolio Online Reporting Tools regarding lifetime peer-reviewed publications and quantity/monetary sum of NIH grants received by medical school deans. Descriptive statistics, independent sample T-tests, and ANOVA were performed with statistical significance defined as P < 0.05.

RESULTS: Women occupied 33/157 (21.0%) dean positions overall. Compared to women, men possess higher mean number of lifetime peer-reviewed publications (112.0 vs. 55.2, P = 0.001) and H-index (43.2 vs. 25.7, P = 0.001); however, there are no differences in the mean number of NIH grants (27.5 vs. 19.1, P = 0.323) nor mean total NIH funding received ($18,931,336 vs. $14,289,529, P = 0.524). While significant differences in mean H-index between all US regions were found (P = 0.002), no significant differences exist between major US regions regarding the mean lifetime publication count (P = 0.223), NIH grants received (P = 0.200), nor total NIH funding (P = 0.824) received.

CONCLUSION: A significant discrepancy in the gender distribution, lifetime peer-reviewed publications, and H-index of allopathic medical school deans exists across the US, highlighting the need for adequate support for women in academic medicine. Greater implementation of mentorship, increased institutional support, and diversity training can improve the representation of women in medical school decanal positions.

PMID:34837733 | DOI:10.1016/j.jss.2021.10.018

J Appl Clin Med Phys. 2021 Nov 27. doi: 10.1002/acm2.13480. Online ahead of print.

ABSTRACT

PURPOSE: The purpose of this study was to investigate the matching error that occurs when the Mobius3D fingerprinting system is applied in conjunction with an Elekta linear accelerator (LINAC) and to offer an acceptable and alternative method for circumventing this problem.

MATERIAL AND METHODS: To avoid the multileaf collimator (MLC) conflicting error in the Mobius3D fingerprinting system, we developed an in-house program to move the MLC in the Digital Imaging and Communications in Medicine (DICOM) radiotherapy (RT)-Plan to pertinent positions, considering the relationship between log data and planned data. The re-delivered log files were calculated in the Mobius3D system, and the results were compared with those of corrected data (i.e., we analyzed a pair of re-collected log data and the previous DICOM RT-Plan data). The results were then evaluated by comparing several items, such as point dose errors, gamma index (GI) passing rates, and MLC root-mean-square (RMS) values.

RESULTS: For the point dose error, the maximum difference found was below 2.0%. In the case of GI analysis of all plans, the maximum difference in the passing rates was below 1.4%. The statistical results obtained using a paired Student’s t-test showed that there were no significant differences within the uncertainty. In the case of the RMS test, the maximum difference found was approximately 0.08 mm.

CONCLUSIONS: Our results showed that all the mismatched log files were sufficiently acceptable within the uncertainty. We conclude that the matching error obtained when applying Mobius3D to an Elekta LINAC may be addressed using a simple modification of the fingerprinting system, and we expect that our study findings will help vendors resolve this issue in the near future.

PMID:34837723 | DOI:10.1002/acm2.13480

Cell J. 2021 Oct;23(5):544-551. doi: 10.22074/cellj.2021.7606. Epub 2021 Oct 30.

ABSTRACT

OBJECTIVE: In cancer treatments, smart gene delivery via nanoparticles (NPs) can be targeted for cancer cells, while concurrently minimizing damage to healthy cells. This study assessed the efficiency of poly lactic-co-glycolic acid (PLGA)-miR 143/206 transfection on apoptosis in mouse leukemia cancer cells (El4) and spermatogonial stem cells (SSCs).

MATERIALS AND METHODS: In this experimental study, neonatal mouse spermatogonia cells and EL4 cancer cell lines were used. MicroRNA-PLGA NPs were prepared, characterized, and targeted with folate. Several doses were evaluated to obtain a suitable miR dose that can induce appropriate apoptosis in EL4 cells, while not harming SSCs. Cells were treated separately at 3 doses of each miR (for miR 143, doses of 25, 50 and 75 nmol and for miR 206, doses of 50, 100 and 150 nmol). The experiments were performed at 24, 48 and 72 hours. Viability and apoptosis were investigated by MTT and Annexin Kits.

RESULTS: Based on MTT assay results, the optimal dose of miR 143 was 75 nmol (59.87 ± 2.85 % SSC and 35.3 ± 0.78 % EL4) (P≤0.05), and for miR 206, the optimal dose was 150 nmol (54.82 ± 6.7 % SSC and 33.92 ± 3.01% EL4) (P≤0.05). The optimal time was 48 hours. At these doses, the survival rate of the EL4 cells was below the half maximal inhibitory concentration (IC₅₀) and SSC survival was above 50%. Annexin V staining also confirmed the selected doses (for miR 143 total apoptosis was 6.62% ± 1.8 SSC and 37.4% ± 4.2 EL4 (P≤0.05), and miR 206 was (10.98% ± 1.5 SSC and 36.4% ± 3.7 EL4, P≤0.05).

CONCLUSION: Using intelligent transfection by NPs, we were able to induce apoptosis on EL4 cells and maintain acceptable SSC survival rates.

PMID:34837682 | DOI:10.22074/cellj.2021.7606

Cell J. 2021 Oct;23(5):516-522. doi: 10.22074/cellj.2021.7849. Epub 2021 Oct 30.

ABSTRACT

OBJECTIVE: Trimethylamine-N-Oxide (TMAO) is considered as a risk factor for atherosclerosis which further leads to inflammation during atherosclerosis. The exact mechanism(s) by which TMAO induces the inflammatory reactions remains to be determined. TMAO can cause the endoplasmic reticulum (ER) stress that triggers activation of Toll-Like Receptors (TLRs). In macrophages, this process stimulates the production of proinflammatory cytokines. This study designed to evaluate the expression level of TLR4 in TMAO-treated macrophages.

MATERIALS AND METHODS: In this experimental study, different concentrations of TMAO (37.5, 75, 150, and 300 μM) were exposed to murine macrophage (J774A.1 cell line) for 8, 18, 24, and 48 hours. The cells were also treated with 2.5 mM of 4-phenyl butyric acid as well as 2μg/ml of tunicamycin respectively as negative and positive controls for inducing ER-stress. We measured the viability of treated cells by the MTT test. Besides, the expression levels of TLR4 gene and protein were evaluated using western blotting and reverse transcription- quantitative polymerase chain reaction (RT-qPCR) analysis. One-Way ANOVA was used for statistical analysis.

RESULTS: No cell death was observed in treated cells. The cells treated with 150 and 300 μM doses of TMAO for 24 hours showed a significant elevation in the protein and/or mRNA levels of TLR4 when compared to normal control or tunicamycin-treated cells.

CONCLUSION: Our results may in part elucidate the mechanism by which TMAO induces the macrophage inflammatory reactions in response to the induction of ER stress, similar to what happens during atherosclerosis. It also provides documentation to support the direct contribution of TLR4 in TMAO-induced inflammation.

PMID:34837678 | DOI:10.22074/cellj.2021.7849

J Esthet Restor Dent. 2021 Nov 27. doi: 10.1111/jerd.12848. Online ahead of print.

ABSTRACT

OBJECTIVES: To investigate effect of distilled alcoholic beverages on surface hardness, roughness, and erosion of bulk-fill resin composites.

MATERIALS AND METHODS: Sixty eight specimens of each bulk-fill resin composite (Filtek One Bulk Fill Restorative, SonicFill 2, and Tetric N-Ceram Bulk Fill) were prepared. Baseline data of surface hardness and roughness value were recorded. The specimens were divided into five groups: vodka, whisky, tequila, brandy, and deionized water (served as a control). Specimens were then alternately immersed in 25 ml of a storage agent for 5 s and in 25 ml of artificial saliva for 5 s over 10 cycles. This process was repeated for 14 days. After immersion, specimens were subjected to evaluation of surface hardness, roughness, and erosion on days 7 and 14. The data were statistically analyzed by two-way repeated analysis of variance, Tukey’s honestly significant difference, and a t test (p < 0.05).

RESULTS: Distilled alcoholic beverages caused significant hardness decrement, roughness and erosion increment (p < 0.05), where the greatest degradation was found in brandy group. Tetric N-Ceram Bulk Fill had the most significant decrement in hardness and increment in roughness and erosion than the other resin composites (p < 0.05).

CONCLUSION: Distilled alcoholic beverages affected hardness, roughness, and erosion of all the bulk-fill resin composites.

CLINICAL SIGNIFICANCE: Regarding the bulk-fill resin composites tested, Filtek One Bulk Fill Restorative was the most appropriate restorative material in patients who consume distilled alcoholic beverages.

PMID:34837668 | DOI:10.1111/jerd.12848

PM R. 2021 Nov 27. doi: 10.1002/pmrj.12741. Online ahead of print.

ABSTRACT

INTRODUCTION: Better tools are needed to predict functional decline and oncologic prognosis in inpatient cancer rehabilitation. The Karnofky Performance Status (KPS) is a widely used scale of functional performance in oncology, although the scale differs from current rehabilitation terminology. Use of the KPS in inpatient rehabilitation may support a shared method of communication between cancer rehabilitation providers and the primary oncology teams.

OBJECTIVE: To establish interrater reliability for translation of the KPS for use in inpatient cancer rehabilitation.

DESIGN: Retrospective interrater reliability review.

SETTING: A large inpatient rehabilitation hospital system.

PARTICIPANTS: Fifty randomized charts were chosen for review from a larger database of all patients admitted to an inpatient cancer rehabilitation program in 2020.

INTERVENTION: Not applicable.

MAIN OUTCOME MEASURES: The KPS scale was translated into common inpatient rehabilitation grading consistent with the Continuity and Assessment Record and Evaluation (CARE) Item Set to support its use in this specialty area. Additionally, a list of best practice guidelines and scoring instructions were created to assist raters in determining appropriate levels within the scale. Members of the inpatient cancer rehabilitation team scored all patients within the larger database (n=424) throughout 2020. A blinded rater completed retrospective chart reviews to score the 50- chart sample. A two-way random effects model was used to calculate an intraclass correlation coefficient (ICC) for the KPS scores at each of three time points (premorbid, admission, and discharge).

RESULTS: The KPS interpretation for rehabilitation proved to be statistically reliable for the 50- chart sample. The premorbid KPS interrater reliability was acceptable (ICC=0.67, 95% CI: 0.40, 0.82), admission KPS reliability was good (ICC=0.88, 95% CI: 0.78, 0.93), and discharge reliability was excellent (ICC= 0.96, 95% CI: 0.91, 0.98).

CONCLUSION: The KPS translation at three time points (pre-morbid, admission and discharge) during the inpatient rehabilitation continuum has acceptable interrater reliability. This article is protected by copyright. All rights reserved.

PMID:34837660 | DOI:10.1002/pmrj.12741

Environ Sci Pollut Res Int. 2021 Nov 27. doi: 10.1007/s11356-021-17794-8. Online ahead of print.

ABSTRACT

A growing number of epidemiologic studies have estimated the associations between endocrine-disrupting chemicals and gestational diabetes mellitus (GDM). However, reports on the association between bisphenol A (BPA) substitutes and GDM are limited. This investigation aimed to explore the associations of maternal serum BPA, bisphenol B (BPB), bisphenol F (BPF), bisphenol S (BPS), and tetrabromobisphenol A (TBBPA) with the risk of GDM. A nested case-control study was performed among 500 pregnant women. In conditional logistic regression models, the OR for BPS was significantly increased in the medium exposure groups (OR = 1.77; 95% CI: 1.01, 3.13) compared with the reference group, while BPA (OR: 0.38, 95%CI: 0.29, 0.50) and TBBPA (OR: 0.67, 95%CI: 0.54, 0.85) were negatively associated with the risk of GDM. In the Bayesian kernel machine regression (BKMR) analysis, the joint effect of bisphenols was positively associated with the risk of GDM. BPS showed positively relationship, while BPA and TBBPA showed negatively relationship, respectively. The quantile g-computation revealed a statistically significant and negative joint effect of the five bisphenols on the risk of GDM (OR: 0.57; 95% CI: 0.46, 0.72) with BPA (70.2%), TBBPA (21.3%), and BPB (8.5%) had positive contribution to the overall effect. These findings suggested that BPS had a positive effect on the risk of GDM, while BPA and TBBPA had negative effect on the risk of GDM. Moreover, exposure to the mixture of the five bisphenols was negatively associated with the risk of GDM.

PMID:34837624 | DOI:10.1007/s11356-021-17794-8

Environ Sci Pollut Res Int. 2021 Nov 27. doi: 10.1007/s11356-021-17644-7. Online ahead of print.

ABSTRACT

Metallothionein-like protein concentrations (MT) and three functionally defined fractions of cholinesterase activity (ChE) were quantified in gill and digestive gland homogenates of tropical cup oysters from 5 nearshore locations in the Colombian Caribbean and correlated with sediment and tissue metal (9 metals) and pesticide (22 organophosphates, OPs, and 20 organochlorines-OCPs), as well as water physical-chemical parameters (salinity, pH, temperature, and dissolved oxygen). Tissue and sediment pesticide concentrations were below detection limits in all samples, whereas sediment and tissue metal concentrations exceeded environmental thresholds at several locations. Tissue MT and ChE biomarkers varied by a factor of 5-6 between locations. Inhibition of cholinesterase activity was negligible for all 5 sites, despite spatial-temporal variation in ChE activity, consistent with below-detection OP concentrations. Tissue MT and ChE biomarkers correlated with tissue and metal sediment concentrations, yet, statistically significant covariance between biomarkers and water chemistry parameters was also observed, indicating that both, metal concentrations and physical-chemical variables, are likely to be responsible for generating the observed spatial-temporal variations in biomarker patterns.

PMID:34837617 | DOI:10.1007/s11356-021-17644-7