Nevin Manimala

Intern Emerg Med. 2022 Sep 14. doi: 10.1007/s11739-022-03081-y. Online ahead of print.

ABSTRACT

COVID-19 has rapidly evolved since it was first discovered in December 2019. We aimed to retrospectively review our experience with COVID-19 infection across 2020-2022, focusing on differences in laboratory markers at presentation. Consecutive adult patients admitted to hospital with confirmed COVID-19 infection were retrospectively reviewed across three periods (29/3/2020-29/9/2020, 16/8/2021-13/10/2021 and 1/1/2022-31/1/2022), correlating with the lineages B.1.338, Delta (B.1.617.2) and Omicron (B.1.1.159), respectively. Laboratory findings of the first requested blood test within 24 h of presentation were recorded and correlated with patient outcome. The primary outcome was requirement for oxygen therapy at any point. Inflammatory markers, namely serum ferritin, lactate dehydrogenase (LDH), C-reactive protein (CRP) were significantly lower on presentation during 2022 compared to 2021, corresponding to a milder disease course. More than 80% of 2022 patients had received 2 or more vaccine doses and fully vaccinated patients displayed significantly lower inflammatory markers at presentation. Using 2022 data, a multivariate prediction model was constructed to predict for oxygen requirement, with c-statistic 0.86. Patients in 2022, corresponding with the Omicron variant, displayed a milder disease course, even in hospitalised patients, with the majority not requiring oxygen and lower inflammatory markers. We constructed a simple-to-use risk prediction model with c-statistic 0.86 which may identify individuals who can be safely managed as outpatients in the era of highly transmissible variants.

PMID:36103084 | DOI:10.1007/s11739-022-03081-y

Environ Sci Pollut Res Int. 2022 Sep 14. doi: 10.1007/s11356-022-22985-y. Online ahead of print.

ABSTRACT

Exposure to arsenic (As) from a diet of contaminated rice is a widespread problem and a serious concern in several parts of the world. There is a need to develop sustainable, effective, and reliable strategies to reduce As accumulation in rice. Our goal was to develop and test a simple crop rotation method of alternating rice with the As hyperaccumulator plant, Chinese brake fern (Pteris vitatta L.), to reduce As concentrations in rice grains. A greenhouse column study was performed for 2 years using As-contaminated rice paddy soil from West Bengal. Rice was grown under flooded conditions and irrigated with As-contaminated water to simulate field conditions. Chinese brake fern was grown between two rice cycles in experimental columns, while control columns were left unplanted. Our results show that at the end of two cycles, there was a statistically significant decrease in soil As concentrations in the treatment columns compared to the control columns. After one rotation with the fern, there was a significant decline in As concentrations in rice grains in treatment plants and a concomitant decline in both noncarcinogenic and carcinogenic health risks. Our results indicate that there could be substantial benefit in implementing this simple crop rotation model to help lower human health risks from As exposure via rice ingestion.

PMID:36103075 | DOI:10.1007/s11356-022-22985-y

Behav Res Methods. 2022 Sep 14. doi: 10.3758/s13428-022-01814-7. Online ahead of print.

ABSTRACT

Studies which provide norms of Likert ratings typically report per-item summary statistics. Traditionally, these summary statistics comprise the mean and the standard deviation (SD) of the ratings, and the number of observations. Such summary statistics can preserve the rank order of items, but provide distorted estimates of the relative distances between items because of the ordinal nature of Likert ratings. Inter-item relations in such ordinal scales can be more appropriately modelled by cumulative link mixed effects models (CLMMs). In a series of simulations, and with a reanalysis of an existing rating norms dataset, we show that CLMMs can be used to more accurately norm items, and can provide summary statistics analogous to the traditionally reported means and SDs, but which are disentangled from participants’ response biases. CLMMs can be applied to solve important statistical issues that exist for more traditional analyses of rating norms.

PMID:36103049 | DOI:10.3758/s13428-022-01814-7

Inflammopharmacology. 2022 Sep 14. doi: 10.1007/s10787-022-01065-0. Online ahead of print.

ABSTRACT

BACKGROUND: We aimed to assess the association between opioid addiction and metabolic syndrome (MetS) risk and its components.

METHODS: We used data obtained from the Rafsanjan Cohort Study (RCS), as a part of the prospective epidemiological research studies in IrAN (PERSIAN). The diagnosis of MetS was accomplished using three criteria of the International Diabetes Federation (IDF), Iranian IDF, and National Cholesterol Education Panel-Adult Treatment Panel III (NCEP-ATP III). Using a questionnaire, data for the demographic, anthropometric, and laboratory indices was collected.

RESULTS: The prevalence of MetS was 38.30, 31.58, and 34.42% based on the IDF international, IDF Iranian, and NCEP-ATP III criteria. According to the IDF international criteria, 666 (17.45%) cases were using opioids and there was a statistically significant difference between opioid use and prevalence of MetS (p < 0.001). Based on the NCEP-ATP III criteria, there was a significant difference in the prevalence of MetS based on opioid use (p < 0.001). Use of opioids was associated significantly with a decreased odds of MetS in the multivariate model based on the IDF international (Adjusted OR = 0.85, 95% CI 0.74-0.98) and IDF Iranian criteria (Adjusted OR = 0.83, 95% CI 0.72-0.95).

CONCLUSIONS: Prevalence of MetS was lower in subjects using opioids. Opioid use was associated with a decreased risk of MetS development.

PMID:36103030 | DOI:10.1007/s10787-022-01065-0

Forensic Sci Med Pathol. 2022 Sep 14. doi: 10.1007/s12024-022-00526-w. Online ahead of print.

ABSTRACT

This study aims to determine pelvic anthropometry characteristics and logistic regression formula for adult sex identification obtained from adult three-dimensional pelvic computed tomography images. This study was an observational analytical study with retrospective regression and cross-sectional approach. The population was all patients at Radiology Installation of Dr. Soetomo General Academic Hospital as referral hospital in East Indonesian region, from September to December 2019 who underwent 3D pelvic CT examination. Then, age distribution and pelvic measurements data were obtained. In this case, statistical analysis was conducted for all the data obtained. A number of 204 samples were included in this study. All radiologic components were also significantly different between sexes (p < 0.05) except for transverse diameter of sacral segment (p = 0.180). Moreover, the conjugate pelvic inlet diameter (CPID), the left innominate height (LIH), and sub pubic angle (SPA) showed significant values for regression formula to determine an adult’s sex using 3D pelvic CT. The calculation result > 0 is a prediction for female while < 0 is a prediction for male. From logistic regression model calculation, a high validity value (91.05%) was found with 100% sensitivity to identify male sex and 81.1% specificity to identify female sex. There were differences on radiometric variable characteristics in pelvic anthropometric study among adult Indonesians at Dr. Soetomo General Academic Hospital, Surabaya. The estimated values of pelvic measurements using 3D CT images could develop a pelvic model with a regression formula with high accuracy value using CPID, LIH, and SPA values.

PMID:36103007 | DOI:10.1007/s12024-022-00526-w

Cancer Chemother Pharmacol. 2022 Sep 14. doi: 10.1007/s00280-022-04471-x. Online ahead of print.

ABSTRACT

PURPOSE: To characterize the pharmacokinetics (PK) of zanidatamab including evaluation of the impact of intrinsic and extrinsic patient factors. To investigate alternative dosing regimens to improve caregiver convenience and reduce zanidatamab wastage.

METHODS: Serum zanidatamab concentrations were obtained from 305 patients with advanced or metastatic breast cancer, gastroesophageal adenocarcinoma (GEA), biliary tract cancer, and other HER2-expressing cancers from four ongoing phase I and II clinical trials. Zanidatamab PK were described using population methods. The exposure of alternative dosing regimens and the impact of dose delay was estimated by model simulation.

RESULTS: A two-compartment model with parallel linear and nonlinear clearance from the central compartment adequately described zanidatamab PK. At the recommended dose regimens of 20 mg/kg Q2W and 30 mg/kg Q3W, zanidatamab clearance was primarily linear at steady state. At steady state, 30 mg/kg Q3W zanidatamab returns within 10% of the steady state trough after 2 subsequent doses following either a 1-week or 2-week dose delay. Statistically significant covariates included in the final model were body weight, sex, albumin, GEA cancer type, baseline tumor size, and presence of post-baseline anti-drug antibodies, all of which resulted in less than 30% impact on exposure. Model simulation predicts weight-based and two-tiered flat dosing will result in similar exposure and variability.

CONCLUSION: The identified significant covariates were not considered clinically meaningful. Both weight-based (30 mg/kg Q3W) and two-tiered flat dosing (1800/2400 mg Q3W, 70 kg threshold) strategies are expected to provide similar exposures of zanidatamab.

PMID:36102999 | DOI:10.1007/s00280-022-04471-x

Mar Biotechnol (NY). 2022 Sep 14. doi: 10.1007/s10126-022-10164-6. Online ahead of print.

ABSTRACT

Trichomoniasis is the most common non-viral sexually transmitted infection (STI) in the world caused by Trichomonas vaginalis. Failures in the treatment with the 5-nitroimidazole class including parasite resistance to metronidazole elicit new alternatives. Marine natural products are sources of several relevant molecules, presenting a variety of metabolites with numerous biological activities. In this work, we evaluated the anti-T. vaginalis activity of fungi associated with marine invertebrates by mass spectrometry-based metabolomics approaches. After screening of six marine fungi, extract from Penicillium citrinum FMPV 15 has shown to be 100% active against T. vaginalis, and the gel permeation column on Sephadex LH-20® yielded twelve organic fractions which five showed to be active. Metabolomics and statistical analyses were performed with all the samples (extract and fractions), and several compounds were suggested to be related to the activity. These components include citrinin, dicitrinin C, citreoisocoumarin, dihydrocitrinone, decarboxycitrinin, penicitrinone C, and others. The minimum inhibitory concentration (MIC) value of anti-T. vaginalis activity of citrinin was 200 µM. The marine fungi metabolites show potential as new alternatives to overcome drug resistance in T. vaginalis infections.

PMID:36102994 | DOI:10.1007/s10126-022-10164-6

Int Orthop. 2022 Sep 14. doi: 10.1007/s00264-022-05571-2. Online ahead of print.

ABSTRACT

PURPOSE: The purpose is to verify the intra- and inter-operator reliability of an extramedullary (EM) accelerometer-based smart cutting guide for distal femoral resection during primary total knee arthroplasty (TKA). The hypothesis of the present study was that the use of the device would result in a good correlation between different operators with a difference between repeated measurements of less than 1°.

METHODS: Twenty-five not consecutive patients with knee osteoarthritis undergone to primary TKA using an EM inertial-based cutting guide to perform distal femoral resection. In order to assess the agreement in femoral axis definition of the device, two operators performed three time each the manoeuvres necessary to define axis. Inter-rater agreement was evaluated with Bland and Altman agreement test. Intra-rater repeatability was evaluated analysing average results distribution of repeated measurements. Accuracy of the device was evaluated comparing differences between intra-operative device data with final implant alignment measured on post-operative longstanding x-rays using Students’ t test.

RESULTS: Agreement between the two operators was statistically significant (p < 0.05) with a bias of – 0.4° (95% CI – 0.6° to – 0.2°). Average difference between cut orientation measured with device and final implant position, measured on x-rays, was 0.2° (95% CI – 1.5° to 1.7°) with no statistical difference between the two measurements. Final implant alignment, measured on x-ray, was 90.2°, with 95% of cases distributed within range 88.0° to 92.0° for varus-valgus and 2.8° and with 95% of cases distributed within range 2.0° to 4.0° for flexion-extension.

CONCLUSIONS: The EM accelerometer-based smart cutting guide used to perform distal femoral resection during primary TKA demonstrated a good intra- and inter-operator reliability in the present in vivo study.

PMID:36102981 | DOI:10.1007/s00264-022-05571-2

World J Surg. 2022 Sep 14. doi: 10.1007/s00268-022-06715-6. Online ahead of print.

ABSTRACT

BACKGROUND: Fascial dehiscence (FD) and incisional hernia (IH) pose considerable risks to patients who undergo abdominal surgery, and many preventive strategies have been applied to reduce this risk. An accurate predictive model could aid identification of high-risk patients, who could be targeted for particular care. This study aims to systematically review existing FD and IH prediction models.

METHODS: Prediction models were identified using pre-specified search terms on SCOPUS, PubMed, and Web of Science. Eligible studies included those conducted in adult patients who underwent any kind of abdominal surgery, and reported model performance. Data from the eligible studies were extracted, and the risk of bias (RoB) was assessed using the PROBAST tool. Pooling of C-statistics was performed using a random-effect meta-analysis. [Registration: PROSPERO (CRD42021282463)].

RESULTS: Twelve studies were eligible for review; five were FD prediction model studies. Most included studies had high RoB, especially in the analysis domain. The C-statistics of the FD and IH prediction models ranged from 0.69 to 0.92, but most have yet to be externally validated. Pooled C-statistics (95% CI) were 0.80 (0.74, 0.86) and 0.81 (0.75, 0.86) for the FD (external-validation) and IH prediction model, respectively. Some predictive factors such as body mass index, smoking, emergency operation, and surgical site infection were associated with FD or IH occurrence and were included in multiple models.

CONCLUSIONS: Several models have been developed as an aid for FD and IH prediction, mostly with modest performance and lacking independent validation. New models for specific patient groups may offer clinical utility.

PMID:36102959 | DOI:10.1007/s00268-022-06715-6

Orthop Surg. 2022 Sep 14. doi: 10.1111/os.13492. Online ahead of print.

ABSTRACT

OBJECTIVE: A detailed analysis of the morphology of distal humeral articulation can help in the creation of anatomic prostheses of hemiarthroplasty. This study used statistical shape modeling to evaluate the 3D morphology of the distal humerus in healthy Chinese individuals and to investigate the proper articular morphology differences.

METHODS: A statistical shape model (SSM) of the distal humerus was created using CT scans of 106 survey-confirmed nonpathologic elbows. In addition, the articular components of each principal component (PC) were selected and fitted on the mean mode. The Euclidean point-to-mesh distance of articular modes was calculated as a measurement the proper change in the morphology of the articulation.

RESULTS: The first seven PCs jointly accounted for 80.9% of the total variation (44.4%, 12.2%, 7.9%, 5.9%, 4.1%, 3.4% and 3%, respectively). In the mean model, the distance between the medial and lateral epicondyles was 57.4 mm, the width of the articulation was 42.1 mm, and the angle of the transepicondylar line (TEL) and C line was 4.8°. The articular surface differences of the first PC were significant (RMS: 1.43 mm in the -3 SD model and 2.38 mm in the +3 SD model), whereas under other conditions, the differences were not remarkable despite the maximum deformation not exceeding 1 mm.

CONCLUSION: A novel method (SSM) was used to evaluate the 3D morphology of the distal humerus in healthy Chinese individuals and investigate the proper articular shape differences. We found the proper shape of articular surface basically transformed into one variation pattern which was relevant to the bone size, even though the morphology of distal humerus possessed complicated variation modes. The findings of this study can be helpful to design the next generation of elbow hemiarthroplasty in the future.

PMID:36102259 | DOI:10.1111/os.13492