Nevin Manimala

J Med Imaging Radiat Oncol. 2021 Nov 19. doi: 10.1111/1754-9485.13350. Online ahead of print.

ABSTRACT

INTRODUCTION: To optimize CT chest protocol by comparing venous contrast timing with arterial timing for contrast opacification in vessels, qualitative image quality and radiologists’ satisfaction and diagnostic confidence in assessing for potential nodal, pleural and pulmonary disease in general oncology outpatients.

METHOD: Matched case-control study performed following CT protocol update. 92 patients with a range of primary malignancies with 2 CT chests in a 2-year period, one with an arterial phase protocol and the second in the 60 second venous phase, were included. Contrast attenuation in aorta, pulmonary artery and liver were measured. Subjective measurements assessed perivenous artefact, confidence in nodal pleural and pulmonary assessment and presence of pulmonary emboli. Statistical analysis was performed using paired and unpaired t-tests.

RESULTS: Venous-phase CT demonstrated more consistent enhancement of the vessels, with higher attenuation of the nodes, pulmonary and pleural lesions. There was a significant reduction in perivenous beam hardening artefact on venous-phase CT (P < 0.001). Diagnostic confidence was significantly higher for nodal assessment and pleural abnormality visibility (P < 0.001) and pleural assessment (P < 0.05). There was no significant difference in pulmonary mass visibility. There was adequate enhancement to diagnose significant pulmonary emboli (PE) with 4 incidental PEs detected on the venous phase, extending to segmental vessels.

CONCLUSION: Venous-phase CT chest performs better than arterial-phase on all fronts, without compromising assessment of incidental pulmonary emboli. When intravenous contrast is indicated in a routine chest CT (excluding a CT-angiogram), the default timing should be a venous or 60s phase.

PMID:34799981 | DOI:10.1111/1754-9485.13350

J Nurs Scholarsh. 2021 Nov 19. doi: 10.1111/jnu.12745. Online ahead of print.

ABSTRACT

PURPOSE: While nurse editors carry great responsibility for the scientific literature in the nursing profession, little has been published about this unique role. The purpose of this study was to examine contemporary nurse editors’ roles and practices.

DESIGN: In early 2019, a sample of 129 nurse editors participated in a cross-sectional study using survey methods.

METHODS: The online survey was based on an instrument used in a prior study and included 43 primarily multiple-choice questions. Findings were analyzed using descriptive statistics.

FINDINGS: Beyond the expected roles of journal management, editorial decision making, leadership for the profession, and specific journal focus, some aspects of the nurse editor role have remained unchanged. The role continues to be learned mostly on the job and nurse editors still find satisfaction in helping other nurses publish and disseminate their work. Nurse editors are older and better educated. They also are receiving more manuscripts submitted to their journals and perceive this role as hard work but worth it. This is also the first study to report on the role of other levels of editors.

CONCLUSION: This study provides a description of the current roles and practices of nurse editors. Nurse editors can bring more attention to the role and encourage more nurses to consider this role as an attainable and a satisfying one.

CLINICAL RELEVANCE: Being a nurse editor is a leadership role and one that many nurses may not consider as a career goal. Nurse editors can increase the visibility of this role and engage, encourage, and support nurses who are interested in this role.

PMID:34799979 | DOI:10.1111/jnu.12745

J Magn Reson Imaging. 2021 Nov 19. doi: 10.1002/jmri.28000. Online ahead of print.

ABSTRACT

BACKGROUND: The majority of heart failure (HF) in hypertrophic cardiomyopathy (HCM) manifests as a phenotype with preserved left ventricular (LV) ejection fraction; however, the exact contribution of left atrial (LA) phasic function to HF with preserved ejection fraction (HFpEF) in HCM remains unresolved.

PURPOSE: To define the association between LA function and HFpEF in HCM patients using cardiac magnetic resonance imaging (MRI) feature tracking.

STUDY TYPE: Retrospective.

POPULATION: One hundred and fifty-four HCM patients (HFpEF vs. non-HF: 55 [34 females] vs. 99 [43 females]).

FIELD STRENGTH/SEQUENCE: 3.0 T/balanced steady-state free precession.

ASSESSMENT: LA reservoir function (reservoir strain [ε_s ], total ejection fraction [EF]), conduit function (conduit strain [ε_e ], passive EF), booster-pump function (booster strain [ε_a ] and active EF), LA volume index, and LV global longitudinal strain (LV GLS) were evaluated in HCM patients.

STATISTICAL TESTS: Chi-square test, Student’s t-test, Mann-Whitney U test, multivariate linear regression, logistic regression, and net reclassification analysis were used. Two-sided P < 0.05 was considered statistically significant.

RESULTS: No significant difference was found in LV GLS between the non-HF and HFpEF group (-10.67 ± 3.14% vs. -10.14 ± 4.01%, P = 0.397), whereas the HFpEF group had more severely impaired LA phasic strain (ε_s : 27.40 [22.60, 35.80] vs. 18.15 [11.98, 25.90]; ε_e : 13.80 [9.20, 18.90] vs. 7.95 [4.30, 14.35]; ε_a : 13.50 [9.90, 17.10] vs. 7.90 [5.40, 14.15]). LA total EF (37.91 [29.54, 47.94] vs. 47.49 [39.18, 55.01]), passive EF (14.70 [7.41, 21.49] vs. 18.07 [9.32, 24.78]), and active EF (27.19 [17.79, 36.60] vs. 36.64 [26.63, 42.71]) were all significantly decreased in HFpEF patients compared with non-HF patients. LA reservoir (β = 0.90 [0.85, 0.96]), conduit (β = 0.93 [0.87, 0.99]), and booster (β = 0.86 [0.78, 0.95]) strain were independently associated with HFpEF in HCM patients. The model including reservoir strain (Net Reclassification Index [NRI]: 0.260) or booster strain (NRI: 0.325) improved the reclassification of HFpEF based on LV GLS and minimum left atrial volume index (LAVI_min ).

DATA CONCLUSION: LA phasic function was severely impaired in HCM patients with HFpEF, whereas LV function was not further impaired compared with non-HF patients.

LEVEL OF EVIDENCE: 4 TECHNICAL EFFICACY: Stage 3.

PMID:34799953 | DOI:10.1002/jmri.28000

J Magn Reson Imaging. 2021 Nov 19. doi: 10.1002/jmri.28002. Online ahead of print.

ABSTRACT

BACKGROUND: Advanced magnetic resonance imaging (MRI) methods are increasingly being used to assess the human placenta. Yet, the structure-function interplay in normal placentas and their associations with pregnancy risks are not fully understood.

PURPOSE: To characterize the normal human placental structure (volume and umbilical cord centricity index (CI)) and function (perfusion) ex-vivo using MRI, to assess their association with birth weight (BW), and identify imaging-markers for placentas at risk for dysfunction.

STUDY TYPE: Prospective.

POPULATION: Twenty normal term ex-vivo placentas.

FIELD STRENGTH/SEQUENCE: 3 T/ T₁ and T₂ weighted (T₁ W, T₂ W) turbo spin-echo, three-dimensional susceptibility-weighted image, and time-resolved angiography with interleaved stochastic trajectories (TWIST), during passage of a contrast agent using MRI compatible perfusion system that mimics placental flow.

ASSESSMENT: Placental volume and CI were manually extracted from the T₁ W images by a fetal-placental MRI scientist (D.L., 7 years of experience). Perfusion maps including bolus arrival-time and full-width at half maximum were calculated from the TWIST data. Mean values, entropy, and asymmetries were calculated from each perfusion map, relating to both the whole placenta and volumes of interest (VOIs) within the umbilical cord and its daughter blood vessels.

STATISTICAL TESTS: Pearson correlations with correction for multiple comparisons using false discovery rate were performed between structural and functional parameters, and with BW, with P < 0.05 considered significant.

RESULTS: All placentas were successfully perfused and scanned. Significant correlations were found between whole placenta and VOIs perfusion parameters (mean R = 0.76 ± 0.06, range = 0.67-0.89), which were also significantly correlated with CI (mean R = 0.72 ± 0.05, range = 0.65-0.79). BW was correlated with placental volume (R = 0.62), but not with CI (P = 0.40). BW was also correlated with local perfusion asymmetry (R = -0.71).

DATA CONCLUSION: Results demonstrate a gradient of placental function, associated with CI and suggest several ex-vivo imaging-markers that might indicate an increased risk for placental dysfunction.

LEVEL OF EVIDENCE: 1 TECHNICAL EFFICACY: Stage 1.

PMID:34799945 | DOI:10.1002/jmri.28002

Child Care Health Dev. 2021 Nov 20. doi: 10.1111/cch.12932. Online ahead of print.

ABSTRACT

BACKGROUND: Developmental delay (DD) indicates a failure to meet the developmental milestones of most children of the same age. Studies based solely on the ICD coding manual may underestimate the prevalence of DD. Real-world use of rehabilitation data may be useful in the identification of more DD children previously undiagnosed with DD.

AIMS: To estimate the prevalence of DD among children aged 0-6 by age and sex in Taiwan based on modified ICD codes.

METHODS: A list of ICD codes specific to DD (including delays and disabilities requiring early intervention) was generated from the existing ICD codebook and modified based on National Health Insurance (NHI) claims data pertaining to developmental rehabilitation of children aged 0-6. The validity of the codes was subsequently assessed by DD experts in various fields using the consensus development technique. The resulting list was used to estimate the prevalence of DD among children in Taiwan from 2000 to 2015 based on analysis of longitudinal NHI data.

RESULT: Between 2000 and 2015, the prevalence of DD among children aged 0 to 6 years increased from 2.0% to 5.7 % and the sex ratio was 181-197 males per 100 females. The prevalence estimate obtained in this study (5.6%) was 229% higher than existing government statistics (1.6%) published in 2014.

CONCLUSIONS: The codes developed using claims data in this study can be used to estimate the prevalence of DD among children and evaluate the effectiveness of intervention programs. Consistent increases in the prevalence of DD indicate that efforts to promote early intervention have been effective. Nonetheless, the low prevalence rate among 0-2y children with developmental delay and low prevalence rate of female CWDD means that the policy should notice the lack of access to healthcare services for infants and female children, and produce a more equitable or fair distribution of healthcare resources.

PMID:34799877 | DOI:10.1111/cch.12932

J Forensic Sci. 2021 Nov 19. doi: 10.1111/1556-4029.14947. Online ahead of print.

ABSTRACT

Sex estimation methods using traditional cranial nonmetric traits utilize predictive models to produce a final sex estimation, using the resulting model’s score to classify the individual. When sex estimations are assigned from discriminant scoring alone, statistical confidence in the resultant estimate is not always assessed or reported. Although some forensic anthropologists may qualitatively report their confidence in the assessment (e.g., “probable male”), these statements are subjective, not standardized, and not necessarily based on statistical results in a uniform way. The goals of this study were to evaluate how posterior probability-informed thresholds (PPITs) impacted accuracy rates, assess the balance between sample inclusion and accuracy for the proposed PPIT approach, and make recommendations for the use and interpretation of specific thresholds in casework. Using a sample of U.S. Black and White females and males (n = 292), we examined how PPITs can standardize the decision-making process of inferring sex for two methods using nonmetric cranial traits. We found that using PPITs of at least 0.85 increased accuracy (over 92% for some PPITs) yet remained highly inclusive of the sample. PPITs < 0.75 did not produce classification accuracy rates significantly higher than chance, and when using these cranial trait sex estimation methods, cases with posterior probabilities (PPs) <0.75 should be reported as “indeterminate.” The 0.75-0.84 PPIT interval had an accuracy rate of 76%, which was both statistically significantly different from chance as well as from the higher (>0.85) groups, suggesting that although sex estimation at this level may be acceptable, the results hold lower confidence.

PMID:34799862 | DOI:10.1111/1556-4029.14947

J Forensic Sci. 2021 Nov 19. doi: 10.1111/1556-4029.14946. Online ahead of print.

ABSTRACT

Aluminum (Al) powder is commonly encountered in improvised explosive devices (IEDs) as a metallic fuel due to its availability and low cost. Although available commercially in powder form, amateur bomb-makers also produce their own Al powder via simple methods found online. In order to provide investigative leads and forensic intelligence, it is important to evaluate not only the composition of homemade devices, but also to distinguish between the various forms of Al powder they contain. To achieve this goal, a method using automated microscopy in combination with statistical techniques has been demonstrated to have the potential to provide source discrimination and investigative leads in source attribution of Al powders in IEDs. The present research refined this method and investigated 59 industrially and amateurly produced Al powder sources with seven subsamples per source using two traditional linear discriminant analyses (LDA), one with a standard data split for training and testing, and another using leave-one-out cross-validation. Averaging the classification accuracies for the two LDA-based analyses, LDA has the ability to correctly classify 59.26%, 83.35%, and 80.69% of the samples based on their powder source, type, and production method, respectively. This classification accuracy represents a 3407%, 317%, and 61.38% increase in accuracy from random class assignment, respectively. Further, in most instances of incorrect data attribution to a particular source, the subsample has been misidentified with another sample of the same powder type or production method.

PMID:34799855 | DOI:10.1111/1556-4029.14946

Risk Anal. 2021 Nov 19. doi: 10.1111/risa.13858. Online ahead of print.

ABSTRACT

In this study, we propose a time-dependent susceptible-exposed-infected-recovered (SEIR) model for the analysis of the SARS-CoV-2 epidemic outbreak in three different countries, the United States, Italy, and Iceland using public data inherent the numbers of the epidemic wave. Since several types and grades of actions were adopted by the governments, including travel restrictions, social distancing, or limitation of movement, we want to investigate how these measures can affect the epidemic curve of the infectious population. The parameters of interest for the SEIR model were estimated employing a composite likelihood approach. Moreover, standard errors have been corrected for temporal dependence. The adoption of restrictive measures results in flatten epidemic curves, and the future evolution indicated a decrease in the number of cases.

PMID:34799850 | DOI:10.1111/risa.13858

Eur Arch Paediatr Dent. 2021 Nov 20. doi: 10.1007/s40368-021-00664-9. Online ahead of print.

ABSTRACT

PURPOSE: Osteogenesis imperfecta (OI) results from mutations in the genes involved in the modification or biosynthesis of collagen. This study aimed to assess the oral health-related quality of life (OHRQoL) in children with OI.

METHODOLOGY: Participants were recruited from a highly specialised OI centre for children. The Child Oral-Health Impact Profile-Short Form (COHIP-SF) was used, adding demographic and qualitative questions. Children aged 8-16 years participated between January and October 2019. Statistical analysis was carried out. A higher COHIP-SF score indicates better OHRQoL (maximum score, 76).

RESULTS: One hundred and six (106) children participated (44 female, mean age 11.93 years). COHIP-SF median score was 59. Children reporting mild OI (n = 55) had higher median scores (62) compared to severe OI (n = 7) with median scores of 55 (P = 0.087). When comparing mixed (< 12 years, n = 46) and permanent dentition (≥ 12, n = 60), no significant difference in OHRQoL was seen (P = 0.977). There was no significant difference between severities for each COHIP-SF domain. Limited data on the presence of dentinogenesis imperfecta did not impact overall score (P = 0.109), but was significant in the oral-health domain (P = 0.033).

QUALITATIVE: Common themes were the need for braces, discolouration, pain and function.

CONCLUSION: This study confirmed that children with OI have dental concerns in areas including oral health, functional well-being and socio-emotional well-being. This was related to severity of OI.

PMID:34799841 | DOI:10.1007/s40368-021-00664-9

Diabetes Ther. 2021 Nov 19. doi: 10.1007/s13300-021-01174-z. Online ahead of print.

ABSTRACT

Limiting postprandial glycemic response (PPGR) is an important intervention in reducing the risk of chronic metabolic diseases and has been shown to impart significant health benefits in people with elevated levels of blood sugar. In this study, we collected gut microbiome activity data by assessing the metatranscriptome, and we measured the glycemic responses of 550 adults who consumed more than 30,000 meals, collectively, from omnivore or vegetarian/gluten-free diets. We demonstrate that gut microbiome activity, anthropometric factors, and food macronutrients modulate individual variation in glycemic response. We employ two predictive models, including a mixed-effects linear regression model (R = 0.77) and a gradient boosting machine model (R_train = 0.80/R²_train = 0.64; R_test = 0.64/R²_test = 0.40), which demonstrate variation in PPGR between individuals when ingesting the same foods. All features in the final mixed-effects linear regression model were significant (p < 0.05) except for two features which were retained as suggestive: glutamine production pathways (p = 0.08) and the interaction between tyrosine metabolizers and carbs (p = 0.06). We introduce molecular functions as features in these two models, aggregated from microbial activity data, and show their statistically significant contributions to glycemic control. In summary, we demonstrate for the first time that metatranscriptomic activity of the gut microbiome is correlated with PPGR among adults.

PMID:34799839 | DOI:10.1007/s13300-021-01174-z