Nevin Manimala

Medicine (Baltimore). 2022 Nov 4;101(44):e31436. doi: 10.1097/MD.0000000000031436.

ABSTRACT

BACKGROUND: Multiple studies have revealed that Traditional Chinese Medicine (TCM) prescriptions can provide protective effect on the cardiovascular system, increase the heart rate and relieve the symptoms of patients with bradyarrhythmia. In China, the TCM treatment of bradyarrhythmia is very common, which is also an effective complementary therapy. In order to further understand the application of Chinese medicines in bradyarrhythmia, we analyzed the medication rules of TCM prescriptions for bradyarrhythmia by data mining methods based on previous clinical studies.

METHODS: We searched studies reporting the clinical effect of TCM on bradyarrhythmia in the PubMed and Chinese databases China National Knowledge Infrastructure database, and estimated publication bias by risk of bias tools ROB 2. Descriptive analysis, hierarchical clustering analysis and association rule analysis based on Apriori algorithm were carried out by Microsoft Excel, SPSS Modeler, SPSS Statistics and Rstidio, respectively. Association rules, co-occurrence and clustering among Chinese medicines were found.

RESULTS: A total of 48 studies were included in our study. Among the total 99 kinds of Chinese medicines, 22 high-frequency herbs were included. Four new prescriptions were obtained by hierarchical cluster analysis. 81 association rules were found based on association rule analysis, and a core prescription was intuitively based on the grouping matrix of the top 15 association rules (based on confidence level), of which Guizhi, Zhigancao, Wuweizi, Chuanxiong, Danshen, Danggui, Huangqi, Maidong, Dangshen, Rougui were the most strongly correlated herbs and in the core position.

CONCLUSION: In this study, data mining strategy was applied to explore the TCM prescription for the treatment of bradyarrhythmia, and high-frequency herbs and core prescription were found. The core prescription was in line with the treatment ideas of TCM for bradyarrhythmia, which could intervene the disease from different aspects and adjust the patient’s Qi, blood, Yin and Yang, so as to achieve the purpose of treatment.

PMID:36343087 | DOI:10.1097/MD.0000000000031436

Medicine (Baltimore). 2022 Nov 4;101(44):e31708. doi: 10.1097/MD.0000000000031708.

ABSTRACT

This study aimed to evaluate the diagnostic performance of dynamic susceptibility contrast (DSC) perfusion magnetic resonance imaging and apparent diffusion coefficient (ADC) for differentiating common posterior fossa tumors, pilocytic astrocytoma (PA), medulloblastoma (MB), and hemangioblastoma (HB). Between January 2016 and April 2022, we enrolled 23 (median age, 7 years [range, 2-26]; 12 female), 13 (10 years [1-24]; 3 female), and 12 (43 years [23-73]; 7 female) patients with PA, MB, and HB, respectively. Normalized relative cerebral blood volume and flow (nrCBV and nrCBF) and normalized mean ADC (nADCmean) were calculated from volume-of-interest and statistically compared. nADCmean was significantly higher in PA than in MB (PA: median, 2.2 [range, 1.59-2.65] vs MB: 0.93 [0.70-1.37], P < .001). nrCBF was significantly higher in HB than in PA and MB (PA: 1.10 [0.54-2.26] vs MB: 1.62 [0.93-3.16] vs HB: 7.83 [2.75-20.1], all P < .001). nrCBV was significantly different between all 3 tumor types (PA: 0.89 [0.34-2.28] vs MB: 1.69 [0.93-4.23] vs HB: 8.48 [4.59-16.3], P = .008 for PA vs MB; P < .001 for PA vs HB and MB vs HB). All tumors were successfully differentiated using an algorithmic approach with a threshold value of 4.58 for nrCBV and subsequent threshold value of 1.38 for nADCmean. DSC parameters and nADCmean were significantly different between PA, MB, and HB. An algorithmic approach combining nrCBV and nADCmean may be useful for differentiating these tumor types.

PMID:36343086 | DOI:10.1097/MD.0000000000031708

Medicine (Baltimore). 2022 Nov 4;101(44):e31441. doi: 10.1097/MD.0000000000031441.

ABSTRACT

BACKGROUND: A common concern in the literature is the comparison of the similarities and differences between research journals, as well as the types of research they publish. At present, there are no clear methodologies that can be applied to a given article of interest. When authors use an effective and efficient method to locate journals in similar fields, they benefit greatly. By using the forest plot and major medical subject headings (MeSH terms) of Spine (Phila Pa 1976) compared to Spine J, this study: displays relatively similar journals to the target journal online and identifies the effect of the similarity odds ratio of Spine (Phila Pa 1976) compared to Spine J.

METHODS: From the PubMed library, we downloaded 1000 of the most recent top 20 most similar articles related to Spine (Phila Pa 1976) and then plotted the clusters of related journals using social network analysis (SNA). The forest plot was used to compare the differences in MeSH terms for 2 journals (Spine (Phila Pa 1976) and Spine J) based on odds ratios. The heterogeneity of the data was evaluated using the Q statistic and the I-square (I2) index.

RESULTS: This study shows that: the journals related to Spine (Phila Pa 1976) can easily be presented on a dashboard via Google Maps; 8 journal clusters were identified using SNA; the 3 most frequently searched MeSH terms are surgery, diagnostic imaging, and methods; and the odds ratios of MeSH terms only show significant differences with the keyword “surgery” between Spine (Phila Pa 1976) and Spine J with homogeneity at I2 = 17.7% (P = .27).

CONCLUSIONS: The SNA and forest plot provide a detailed overview of the inter-journal relationships and the target journal using MeSH terms. Based on the findings of this research, readers are provided with knowledge and concept diagrams that can be used in future submissions to related journals.

PMID:36343077 | DOI:10.1097/MD.0000000000031441

Medicine (Baltimore). 2022 Nov 4;101(44):e31624. doi: 10.1097/MD.0000000000031624.

ABSTRACT

BACKGROUND: Safety and efficacy were assessed of different S(+)-ketamine doses combined with propofol administered as anesthesia to common pediatric congenital heart disease (CHD) patients undergoing cardiac interventional surgery to provide reference data as guidance for use in clinical settings.

METHODS: Sixty CHD children admitted to Beijing Anzhen Hospital, Capital Medical University from December 2020 to December 2021 who underwent elective cardiac intervention were assigned to 3 groups (H, L, M, 20 patients/group) using a random number table-based method. Patients received 1% propofol (2 mg/kg) and intravenous injections of S(+)-ketamine (Group L, 0.4 mg/kg; Group M, 0.5 mg/kg; Group H, 0.6 mg/kg) followed by intravenous pumping of 1% propofol (4-6 mg/kg/h). Heart rate (HR), mean arterial pressure, and pulse oxygen saturation were recorded preoperatively (T0), at the time of anesthesia maintenance (T1), at the time of arteriovenous puncture (T2), and when they awakened (T3). Additionally, propofol dose and incidence rates of intraoperative body movement, postoperative agitation, and postoperative nausea/vomiting were recorded.

RESULTS: For the 3 groups, Group H awakening time was significantly longer than that of Group L (P = .039). Notably, intergroup intraoperative propofol times differed significantly (P = .009). Meanwhile, T0 to T3 intragroup HR values differences were significant (P = .017; P = .001; P = .005, respectively). Group L HR was significantly elevated at T2 relative to T0 (P = .003), Group M HR was significantly elevated at T1 and T2 relative to T0 (P = .019; P = .003, respectively), and Group H HR values were significantly elevated at T1 and T2 relative to T0 (P = .012; P = .005, respectively). At all 4 time points no statistically significant intergroup differences in mean arterial pressure values were observed (P = .587). T1 to T3 pulse oxygen saturation values for all 3 groups were significantly greater than corresponding T0 values. Although intergroup intraoperative body movement incidence differed significantly (P = .044), intergroup differences in awakening time agitation and postoperative nausea/vomiting incidence rates were insignificant (P = .732, P = .887, respectively).

CONCLUSION: Use of 0.6 mg/kg S(+)-ketamine with propofol was most effective as anesthesia for common pediatric CHD patients undergoing cardiac interventional surgery.

PMID:36343069 | DOI:10.1097/MD.0000000000031624

Medicine (Baltimore). 2022 Nov 4;101(44):e31606. doi: 10.1097/MD.0000000000031606.

ABSTRACT

The importance of pain education is widely accepted and recognized. This is a key part of educating the undergraduate and postgraduate healthcare workforce is an essential strategy for promoting effective pain practice. This study aims to evaluate the pain management module training courses for newly graduated doctors to address the knowledge gap between specialist care and primary care physicians. This was an observational study of an evaluation of a pain education project focused on neuropathic pain management core competency was provided. Multimodal teaching approaches such as didactic teaching and vignettes of cases discussion, video teaching, and learning module. A pretest survey was carried out to assess the baseline knowledge of the participants. Completion of the post-test and participant experience questionnaire were collected. Comparison of the pre-and post-test scores for all participants was undertaken using the Wilcoxon signed-ranked test with effect size calculated. The participant’s experience questionnaire scores were analyzed descriptively to produce mean and standard deviations from each question. A total of 274 participants completed all of the course sections from the average of 350 eligible participants. Of 274 participants, more than half were female (64.96%), with more than half participants being General Practitioner (54.38%) followed by a neurologist (35.04%). For all sessions, a Wilcoxon signed-rank test outlined that differences between all pre-and post-test scores were significant (P < .001). There was a marked improvement in the post-test as evidenced by statistically significant increases in mean scores differences. We developed an educational training courses for physicians to address the limitation in existing medical undergraduate training of neuropathic pain management. The training led to improvement in participant’s knowledge and skills with positive outcomes.

PMID:36343056 | DOI:10.1097/MD.0000000000031606

Medicine (Baltimore). 2022 Nov 4;101(44):e31434. doi: 10.1097/MD.0000000000031434.

ABSTRACT

BACKGROUND: Several efforts have been made to improve the glass ionomer cements (GICs) properties with nanotechnology. Fluoride release in once of most beneficial properties of GICs. The purpose of this study was to evaluate the fluoride release, recharge, and cytotoxicity in GICs reinforced with titanium dioxide nanoparticles (TiO2N).

OBJECTIVE: Evaluate the fluoride release, recharge, and cytotoxicity in GICs reinforced with TiO2N.

METHODS: Four GICs, FUJI IX EXTRA (G1c), KETAC MOLAR (G2c), IONOFILL MOLAR (G3c), and FUJI IX (G4c) were combined with TiO2N (G1e, G2e, G3e, and G4e) and divided into blocks of 5-mm width and 1-mm thickness 10 each. A total of 80 samples were arranged as follows: GICs alone as negative control (n = 40) and GICs + TiO2N as experimental groups (n = 40). The fluoride release was determined for periods of 1, 2, 6, 10, 31, 90, 180, 240, and 300 days. On days 30 and 179, samples were recharged by submerging in 1 mL of 20,000 ppm sodium fluoride gel. Cytotoxic activity was carried out with gingival fibroblasts, using 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide cell viability assay.

RESULTS: The experimental groups obtained the highest and more constant fluoride released when compared to control groups. After the first recharge, experimental groups (G1e, G3e, and G4e) showed statistically significant results (P = .001, 0.010, and 0.001 respectively) enhancing their recharge ability regarding control groups. The second recharge showed better results in G1e concerning the rest of the groups. No cytotoxic activity was observed in all experimental groups, although significant differences were observed in G3e and G4e regarding control group.

CONCLUSION: The incorporation of TiO2N enhance the fluoride release in glass ionomers with a noncytotoxic effect on human gingival fibroblasts.

PMID:36343033 | DOI:10.1097/MD.0000000000031434

Autism Res. 2022 Nov 7. doi: 10.1002/aur.2845. Online ahead of print.

ABSTRACT

Measurement invariance, or the degree to which an instrument measures constructs consistently across subgroups, is critical for appropriate interpretations of measures. Given sex differences in the phenotypic and clinical presentation of autism spectrum disorder (ASD), it is particularly important to examine measurement invariance in autism instruments to ensure that ASD measures are not biased toward the more common male ASD phenotype. This study represents an important preliminary investigation evaluating the measurement equivalence of the Autism Impact Measure (AIM) across children and adolescents with ASD. The results indicated that the AIM demonstrated measurement invariance at the configural, metric, and scalar levels across sex in all five domains, including Repetitive Behavior, Communication, Atypical Behavior, Social Reciprocity, and Peer Interaction. These results suggest that ASD core symptoms assessed by the AIM were similar among male and female groups. In addition, the latent means for all five factors were not statistically significantly different across sex groups, revealing no systematic differences on any of the AIM subscales for males and females. Overall, this study showed that the AIM detects core ASD symptoms across all five areas equivalently in males and females and is not biased toward males with ASD.

PMID:36341720 | DOI:10.1002/aur.2845

Australas Psychiatry. 2022 Nov 7:10398562221131160. doi: 10.1177/10398562221131160. Online ahead of print.

ABSTRACT

OBJECTIVES: To identify and characterise medical consultations to psychiatric inpatients.

METHOD: Retrospective cross-sectional descriptive study of 451 psychiatric inpatients’ electronic medical records between 1 January and 30 June 2021 with descriptive statistics.

RESULTS: Thirty one percent (n = 131) of inpatients required medical consultation, with 382 total consultations including ward call. Half (57.9%) were telephone advice. Main consulting specialties were general medicine (25%), anaesthetics (12%), neurology (9.9%), cardiology (6.5%) and endocrinology (6.2%). Almost all (99.0%) consultations resulted in documented management plans.

CONCLUSIONS: This is the first Australian descriptive study quantifying and characterising psychiatric inpatient consultation requests. Physical and psychiatric healthcare integration requires ongoing efforts, including improved referral pathways.

PMID:36341710 | DOI:10.1177/10398562221131160

CNS Neurosci Ther. 2022 Nov 7. doi: 10.1111/cns.14010. Online ahead of print.

ABSTRACT

AIM: The aim of this study was to explore the effectiveness and safety of pentoxifylline as an adjuvant to risperidone in mitigating the negative symptoms in patients with chronic schizophrenia.

METHODS: In this randomized, placebo-controlled study, eighty outpatients with chronic schizophrenia were given risperidone for 8 weeks along with either pentoxifylline or a placebo. The positive and negative syndrome scale (PANSS) was used to assess patients at the start of the trial, as well as at 2, 4, 6, and 8 weeks. Pre- and posttreatment serum levels of cAMP, TNF-α-, and IL-6 were measured.

RESULTS: The pentoxifylline group revealed a significant effect for time-treatment interaction on PANSS-negative subscale scores (p < 0.001), PANSS general psychopathology subscale scores (p < 0.001), and PANSS total scores (p < 0.001), but not on PANSS-positive subscale scores (p = 0.169). Additionally, when compared to the placebo group, the pentoxifylline group demonstrated a statistically significant increase in cAMP serum level and a statistically significant decrease in TNF-α and IL-6 serum levels.

CONCLUSION: Pentoxifylline adjunctive therapy with risperidone for 8 weeks was found to be promising in mitigating the negative symptoms in patients with chronic schizophrenia.

TRIAL REGISTRATION NUMBER: NCT04094207.

PMID:36341700 | DOI:10.1111/cns.14010

Br J Radiol. 2022 Nov 7:20220196. doi: 10.1259/bjr.20220196. Online ahead of print.

ABSTRACT

OBJECTIVE: To compare image quality and diagnostic accuracy of arterial stenosis in low-dose lower-extremity CT angiography (CTA) between adaptive statistical iterative reconstruction-V (ASIR-V) and deep learning image reconstruction (DLIR) algorithms.

METHODS: Forty-six patients undergoing low-dose lower-extremity CTA were enrolled. Images were reconstructed using ASIR-V (blending factor of 50% (AV-50) and 100% (AV-100)) and DLIR (medium (DL-M), and high (DL-H)). CT values and standard deviation (SD) of the aorta, psoas, popliteal artery, popliteal and ankle muscles were measured. The edge-rise-distance (ERD) and edge-rise-slope (ERS) were calculated. The degrees of granularity and edge blurring were assessed using a 5-point scale. The stenosis degrees were measured on the four reconstructions, and their mean-square-errors (MSE) against that of digital subtraction angiography (DSA) were calculated and compared.

RESULTS: For both ASIR-V and DLIR, higher reconstruction intensity generated lower noise and higher SNR and CNR values. The SD values in AV-100 images were significantly lower than other reconstructions. The two DLIR image groups had higher ERS and lower ERD (DL-M:1.79 ± 0.37 mm and DL-H:1.82 ± 0.38 mm vs AV-50:1.96 ± 0.39 mm and AV-100:2.01 ± 0.36 mm, p = 0.014) than ASIR-V images. The overall image quality of DLIR was rated higher than ASIR-V (DL-M:0.83 ± 0.61, DL-H:0.41 ± 0.62, AV-50:1.85 ± 0.60 and AV-100:2.37 ± 0.77, p < 0.001), with DL-H having the highest overall image quality score. For stenosis measurement, DL-H had the lowest MSE compared to DSA among all reconstruction groups.

CONCLUSION: DLIR images had higher image quality ratings with lower image noise and sharper vessel walls in low-dose lower-extremity CTA, and DL-H provides the best overall image quality and highest accuracy in diagnosing artery stenoses.

PMID:36341682 | DOI:10.1259/bjr.20220196